[1]朱耀祖,陈锋,王旭,等.颞浅动脉-大脑中动脉分支吻合联合脑-硬脑膜-肌肉血管融合术治疗烟雾病的效果及对脑血循环的影响[J].临床神经外科杂志,2019,16(5):402-409.[doi:10.3969/j.issn.1672-7770.2019.05.007]
 ZHU Yao-zu,CHEN Feng,WANG Xu,et al.Comparison of STA-MCA+EDMS and conservative therapy for moyamoya disease and its effect on cerebral circulation[J].Journal of Clinical Neurosurgery,2019,16(5):402-409.[doi:10.3969/j.issn.1672-7770.2019.05.007]
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颞浅动脉-大脑中动脉分支吻合联合脑-硬脑膜-肌肉血管融合术治疗烟雾病的效果及对脑血循环的影响()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第5期
页码:
402-409
栏目:
脑血管病专题
出版日期:
2019-10-15

文章信息/Info

Title:
Comparison of STA-MCA+EDMS and conservative therapy for moyamoya disease and its effect on cerebral circulation
作者:
朱耀祖陈锋王旭刘汉东敖祥生张海泉
441021 襄阳,湖北文理学院附属医院,襄阳市中心医院神经外科
Author(s):
ZHU Yao-zu CHEN Feng WANG Xu et al.
Department of Neurosurgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Sciences, Xiangyang 441021, China
关键词:
烟雾病颞浅动脉-大脑中动脉分支吻合联合脑-硬脑膜-肌肉血管融合保守治疗
Keywords:
moyamoya disease STA-MCA+EDMS conservative treatment
分类号:
R651.1
DOI:
10.3969/j.issn.1672-7770.2019.05.007
文献标志码:
A
摘要:
【摘要】目的 探讨颞浅动脉(superficial temporal artery,STA)-大脑中动脉(middle cerebral artery,MCA)分支吻合联合脑-硬脑膜-肌肉血管融合(encepho-duro-myo-synangiosis,EDMS)(STA-MCA+EDMS)术治疗烟雾病的效果及对脑血循环的影响。方法160例烟雾病患者随机分为STA-MCA+EDMS术治疗组(血管重建组)和保守治疗组(对照组),每组各80例。比较两组患者治疗后的临床疗效。在术前和术后3个月,用经颅多普勒检测患者的血流平均速度(Vm)和血管搏动指数(PI)值。随访观察两组患者的预后和死亡情况。结果血管重建组的脑血管造影松岛分级结果优于对照组(P<0.05)。治疗前两组患者Vm和PI值的差异无统计学意义(均P>0.05);治疗后3个月,两组Vm和PI值均比治疗前有显著改善(均P<0.001),而血管重建组的Vm显著高于、PI显著低于对照组(均P<0.001)。治疗前两组患者mRS评分的差异无统计学意义(P>0.05);治疗后3个月两组的mRS评分比治疗前有显著改善(均P<0.001),而血管重建组的mRS评分显著低于对照组(P<0.05)。血管重建组再出血、死亡率显著低于对照组(均P<0.001)。结论相较于保守疗法,STA-MCA+EDMS术对烟雾病具有更好的临床效果,更有助于颅内侧支微循环的改善,减轻患者症状;并减少再出血发生率和死亡率。
Abstract:
bstract: ObjectiveTo explore the effect of superficial temporal artery-brain middle artery branch anastomosis combined with brain-dural-muscle fusion(STA-MCA+EDMS) and conservative treatment of moyamoya disease(MMD) and its effect on Vm and PI. MethodsA total of 160 patients with MMD between May 2015 and May 2018 were randomly divided into two groups, 80 in each group. The control group was treated with conservative therapy and the observation group was treated with STA-MCA + EDMS. The clinical efficacy of the two groups was compared. The mean velocity and pulse index values of the two groups were detected and compared, and the prognosis and mortality of the two groups were followed up. ResultsThe Matsushima classification results of the observation group were better than the control group (P<0.05). There was no significant difference in Vm and PI levels between the two groups before treatment(P>0.05). There was a significant improvement in the 3 months after treatment(all P<0.001), in which the Vm of the observation group was significantly higher than that of the control group(P<0.001). There was no significant difference in mRS score between the two groups before treatment(P>0.05). There was a significant improvement in the 3 months after treatment, and the mRS score of the observation group was significantly lower than that of the control group(P<0.001). The rebleeding and mortality in the observation group were significantly lower than those in the control group(all P<0.001). ConclusionCompared with conservative therapy, STA-MCA+EDMS has a better clinical effect on MMD, and is more conducive to the improvement of the intracranial branch microcirculation, reducing the symptoms of patients and reducing the occurrence of rebleeding and death.

相似文献/References:

[1]陈军,李爱民,陈震.脑血流重建术治疗出血型烟雾病[J].临床神经外科杂志,2016,(01):21.
[2]周平,邓燕,王辉,等.磁共振灌注成像在联合血管重建术治疗烟雾病中的应用[J].临床神经外科杂志,2016,(03):197.
 ZHOU Ping,DENG Yan,WANG Hui,et al.The value of MR perfusion imaging in treatment of moyamoya disease treated by combined revascularization[J].Journal of Clinical Neurosurgery,2016,(5):197.
[3]蔡瑜,顾威庭,李锋,等.间接血管重建术治疗成人烟雾病[J].临床神经外科杂志,2016,(06):439.
 CAI Yu,GU Wei-ting,LI Feng,et al.Appliction of encephalo-duro-arterio-synangiosis in treatment of adults Moyamoya disease[J].Journal of Clinical Neurosurgery,2016,(5):439.
[4]何雪阳,张晋宁,蔡永辉,等.烟雾病合并动脉瘤栓塞治疗6例及文献复习[J].临床神经外科杂志,2017,14(01):52.
 HE Xue-yang,ZHANG Jin-ning,CAI Yong-hui,et al.Endovascular treatment of intracranial aneurysms associated with moyamoya disease[J].Journal of Clinical Neurosurgery,2017,14(5):52.
[5]欧阳光,黄书岚,徐海涛,等.脑血运重建治疗缺血性烟雾病手术时机的选择[J].临床神经外科杂志,2019,16(5):397.[doi:10.3969/j.issn.1672-7770.2019.05.006]
 OUYANG Guang,HUANG Shu-lan,XU Hai-tao,et al.Optimum operation time of revascularization for ischemic moyamoya disease[J].Journal of Clinical Neurosurgery,2019,16(5):397.[doi:10.3969/j.issn.1672-7770.2019.05.006]

更新日期/Last Update: 2019-10-15