颞浅动脉-大脑中动脉吻合术治疗烟雾病的疗效分析

摘要

目的 探讨颞浅动脉-大脑中动脉吻合术治疗烟雾病的疗效、手术要点及术后并发症.方法 28例接受颞浅动脉-大脑中动脉吻合术的烟雾病患者,对其手术前后的临床资料进行回顾分析.结果 28例患者均手术成功,术后复查DSA或CTA示吻合口通畅良好,颅脑CT灌注成像示脑灌注较术前明显改善.随访4 ～48个月,无脑梗死及脑出血患者,3例患者出现短暂性脑缺血发作(TIA),但发作次数及持续时间较术前均明显减少.结论 颞浅动脉-大脑中动脉吻合术治疗烟雾病短期内安全有效,但其长期效果有待进一步研究.%Objective To evaluate the therapeutic effect of superficial temporal artery-middle cerebral artery(STA-MCA) bypass in the treatment of Moyamoya disease.Methods From April 2009 to June 2013,STAMCA bypass operatioas were performed in 28 patients (15 females/13 males,age 6-49 years) with Moyamoya disease.The frontal and parital branches of the superficial temporal artery were separated under the microscope,then anastomosed with the M3 or M4 segment of middle cerebral artery.All clinical and radiological data were retrospectively reviewed.Results All of the operations were successful.Postoperative CT angiography or DSA imaging demonstrated patency of the bypass in all patients.CT perfusion obviously demonstrated improvement of cerebral perfusion.The ischemic symptoms were relieved in most of the patients.3 patients suffered transient ischemic attack (TIA).In 4 patients,the incision showed small amount of exudate and wound healing delayed.During the follow-up period,no cerebral homorrhage or infarction was observed.Conclusion This study showed that the superficial temporal artery-middle cerebral artery bypass could achieve good therapeutic effect in the treatment of Moyamoya disease during the short-term follow-up,but its long-term outcome needs further study.