中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
12期
1228-1231
,共4页
何升学%刘宏毅%邹元杰%马骏%张岩松%黄庆玖%陈永严%章文斌%刘永
何升學%劉宏毅%鄒元傑%馬駿%張巖鬆%黃慶玖%陳永嚴%章文斌%劉永
하승학%류굉의%추원걸%마준%장암송%황경구%진영엄%장문빈%류영
烟雾病%血管重建术%缺血
煙霧病%血管重建術%缺血
연무병%혈관중건술%결혈
Moyamoya disease%Revascularization%Ischemic
目的 初步探讨直接联合间接血管重建术治疗缺血型烟雾病的疗效.方法 对20例缺血型烟雾病患者行直接血管重建术(颞浅动脉-大脑中动脉吻合术)结合脑-硬脑膜-动脉-颞肌融合术,术后随访6个月～2年.术后采用CTA、DSA、MRI及MRI灌注成像评价手术效果.结果 17例缺血型烟雾病患者术后1周、1年的DSA显示吻合血管通畅,其中12例术后2年行DSA检查均显示血管通畅良好,脑膜中动脉、颞中深动脉均与颅内皮层动脉形成不同吻合;18例患者1年内未发生脑缺血发作和脑梗死.结论 直接联合间接血管重建术(STA-MCA吻合术+脑-硬脑膜-肌肉融合术)能同时利用两种手术方式各自优点,可能提高患者的近期和远期疗效,是一种安全、有效的手术方式.
目的 初步探討直接聯閤間接血管重建術治療缺血型煙霧病的療效.方法 對20例缺血型煙霧病患者行直接血管重建術(顳淺動脈-大腦中動脈吻閤術)結閤腦-硬腦膜-動脈-顳肌融閤術,術後隨訪6箇月～2年.術後採用CTA、DSA、MRI及MRI灌註成像評價手術效果.結果 17例缺血型煙霧病患者術後1週、1年的DSA顯示吻閤血管通暢,其中12例術後2年行DSA檢查均顯示血管通暢良好,腦膜中動脈、顳中深動脈均與顱內皮層動脈形成不同吻閤;18例患者1年內未髮生腦缺血髮作和腦梗死.結論 直接聯閤間接血管重建術(STA-MCA吻閤術+腦-硬腦膜-肌肉融閤術)能同時利用兩種手術方式各自優點,可能提高患者的近期和遠期療效,是一種安全、有效的手術方式.
목적 초보탐토직접연합간접혈관중건술치료결혈형연무병적료효.방법 대20례결혈형연무병환자행직접혈관중건술(섭천동맥-대뇌중동맥문합술)결합뇌-경뇌막-동맥-섭기융합술,술후수방6개월～2년.술후채용CTA、DSA、MRI급MRI관주성상평개수술효과.결과 17례결혈형연무병환자술후1주、1년적DSA현시문합혈관통창,기중12례술후2년행DSA검사균현시혈관통창량호,뇌막중동맥、섭중심동맥균여로내피층동맥형성불동문합;18례환자1년내미발생뇌결혈발작화뇌경사.결론 직접연합간접혈관중건술(STA-MCA문합술+뇌-경뇌막-기육융합술)능동시이용량충수술방식각자우점,가능제고환자적근기화원기료효,시일충안전、유효적수술방식.
Objective To investigate the effects of combined direct and indirect revascularization in the treatment of ischemic moyamoya disease.Methods Combined superficial temporal artery middle cerebral artery anastomosis and encephalo-duro-myo-synangiosis (EDMS) were performed in 20 adult patients with ischemic moyamoya disease,who were followedup for six months to two years.The postoperative outcomes were evaluated by CTA,DSA,MRI and PWI.Results The postoperative external carotid angiography at 6 months and 12 months revealed that the STA-MCA bypass was patent in 17 patients.12 of 17 patients were also patent at 24 months after the procedure.The extensive development of surgical collaterals from MMA and deep temporal artery through indirect bypass were observed in all patients.18 patients were free of transient ischemic attack within one year.Conclusions Combined STA MCA bypass and EDMS could provide a significant reciprocal benefit.It was a safe and effective option to improve the short-and long-term outcomes in patients with ischemic moyamoya disease.
