【摘要】：目的探討顳淺動脈-大腦中動脈分支吻合術結合腦-硬膜-顳肌血管貼敷融合術(STA-MCA+EDMS)治療煙霧病手術早期效果及其高灌注綜合征特點。方法通過回顧性分析符合納入標準行STA-MCA+EDMS術的煙霧病患者臨床資料。對比術前術后腦血管造影術結果;統(tǒng)計分析術前及術后6 m神經(jīng)功能狀態(tài)結果;分析術后高灌注綜合征特征。結果 44人,共49次STA-MCA+EDMS術納入本次研究;該術式能確切改善腦供血,顱內(nèi)外血管形成良好交通;25人表示癥狀改善,但腦卒中臨床神經(jīng)功能缺損程度評分量表分析,評分雖有所改善,而無統(tǒng)計學意義;術后發(fā)生高灌注綜合征等不良反應有18人(40.9%),而優(yōu)勢半球側手術明顯增加其發(fā)生概率(P0.05),Matsushima分型中Ⅲ~Ⅵ型潛在風險較高。結論臨床上應根據(jù)煙霧病患者不同特征,進行有效術前評估及積極預后干預。
[Abstract]:Objective to investigate the early effect of superficial temporal arterio-middle cerebral artery anastomosis combined with brain-dura-temporal muscle application (STA-MCA EDMS) in the treatment of moyamoya disease and the characteristics of hyperperfusion syndrome. Methods the clinical data of patients with moyamoya disease were analyzed retrospectively. The results of preoperative and postoperative cerebrovascular angiography were compared, the results of 6 m nerve function before and after operation were statistically analyzed, and the characteristics of postoperative hyperperfusion syndrome were analyzed. Results Forty-four patients, 49 STA-MCA EDMS procedures, were included in the study. The procedure can improve the blood supply of brain and good communication between intracranial and external blood vessels. 25 patients indicated that symptoms were improved, but the clinical neurological deficit scale was used to evaluate the degree of cerebral apoplexy. There were 18 cases (40.9%) of adverse reactions such as hyperperfusion syndrome occurred after operation, while the probability of occurrence was significantly increased in dominant hemispheric surgery (P0.05). The potential risk of type 鈪，

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