目的：探讨颞浅动脉-大脑中动脉吻合术联合脑-硬脑膜-肌肉血管融合术治疗中老年缺血性脑血管病的应用。方法对5例有症状的中老年缺血性脑血管病患者进行了颞浅动脉-大脑中动脉吻合结合脑-硬脑膜-肌肉血管融合术(脑供血动脉联合重建术)，分析围手术期前后及随访的症状、体征及脑血流动力学参数变化情况。结果术后随访5例，随访时间6～24个月，平均14个月，症状均较术前好转或消失。5例患者术前美国国立卫生研究院卒中量表(National Institutes of Health stroke scale，NIHSS)总分为10分，随访时下降到3分；术前改良Rankin量表(modified Rankin scale，MRS)总分为10分，随访时下降到4分。结论在严格选择适应证患者中，脑供血动脉联合重建术治疗中老年缺血性脑血管病效果基本满意。%Objective To explore the treatment of superficial temporal artery-middle cerebral artery anastomosis combined with encephaloduromyosynangiosis for senile ischemic cerebrovascular disease.Method Five patients with symptomatic ischemic cerebrovascular disease were operated with superficial temporal artery-middle cerebral artery anastomosis combined with encephaloduromyosynangiosis (combined extra-intracranial feeding arteries reconstruction operation). The variation of symptoms, signs and the cerebral hemodynamic parameters were analysed in the perioperative and follow-up period. Result All the patients underwent operations successfully.Five patients were followed up from 6 months to 24 months (average 14 months). During the follow-up, symptoms in 5 patients improved or disappeared. The total score of 5 patients evaluated by National Institutes of Health Stroke Scale(NIHSS) was 10 points before surgery and it descended to 3 points in the follow-up;the total preoperative Modified Rankin Scale(MRS)score was 10 points and it descended to 3 points. Conclusion Treatment of superficial temporal artery-middle cerebral artery anastomosis combined with encephaloduromyosynangiosis is good for the senile ischemic cerebrovascular disease with strict operation indication.
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