联合血管重建术治疗烟雾病疗效分析

Analysis of curative effect of the combined revascularization on Moyamoya disease

目的探讨联合血管重建术治疗烟雾病的疗效。方法 2006年1月至2011年3月采用颞浅动脉-大脑中动脉搭桥+颞肌贴敷术治疗烟雾病患者21例,术前1d、术后1周及术后3月采用改良Rankin评分(mRS)进行神经功能评估。结果 21例患者无1例发生颅内血肿等并发症,术后临床功能均有不同程度改善;除2例行双侧血管重建术外其余均行单侧手术治疗;术后常规行MRA或CTA检查均示吻合口均通畅。术前1d、术后1周h术后3月mRS评分分别为(3.05±1.43)分,(2.90±1.58)分,(1.43±1.50)分,术前1d与术后1周mRS评分无明显差异(P>0.05),但术前1d与术后3月和术后1周与术后3月均差异显著(P<0.05)。本组无死亡病例。结论联合血管重建术能有效改善患者症状。

Objective To explore the curative effect of the combined revascularization on Moyamoya disease.Methods The clinical data of 21 patients with Moyamoya disease treated by the combined revascularization including superficial temporal artery middle cerebral artery bypass and encephalo-myo-synagiosis （STA-MCA Bypass ＋ EMS） from January,2006 to March,2011 were analyzed retrospectively.The neurological function was evaluated by modified Rankin Scale （mRS） before the surgery and 1 week and 3 months after the surgery.No patients died.Results The intracranial hematomas did not occurred after the surgery in all the patients.The postoperative MRA or CTA examination showed that all the anatomosed arteries were clear.The outcomes of mRS showed that the neurological function was significantly better 3 months after the surgery than that before the surgery in the patients with Moyamoya disease （P 0.05）.Conclusion The symptoms may be significantly improved by the combined revascularization in the patients with Moyamoya disease.