大动脉粥样硬化型缺血性脑血管病的颅内外血管搭桥治疗(附48例分析)

EC-IC bypass for large-artery atherosclerosis-related ischemic cerebrovascular disease: analysis of 48 cases

目的:评价大动脉粥样硬化(Large-artery atherosclerosis,LA)型缺血性脑血管病颅内外血管搭桥术(EC-IC bypass)的治疗效果,探讨颅内外血管搭桥术在新的历史条件下对于LA型缺血性脑血管病治疗的有效性。方法:回顾性分析48例LA型缺血性脑血管病病人的临床资料,其中短暂性脑缺血发作(TIA)36例,语言功能障碍8例,单侧肢体轻瘫4例。根据临床症状结合术前影像学资料,行颅内外血管搭桥术治疗。根据术后临床症状改善情况,并对比手术前后影像学资料的变化,对颅内外血管搭桥术治疗效果进行评价。结果:TIA病人中,1例术后出现卒中事件,其余35例术后TIA症状消失;语言功能障碍和单侧肢体轻瘫病人术后半年症状均有改善;40例LA型缺血性脑血管病病人术后影像学复查均获满意效果。结论:颅内外血管搭桥术对于LA型缺血性脑血管病的预防和治疗是有效的。

Objective： To evaluate and explore the efficacy of EC-IC bypass for large-artery atherosclerosis-related ischemie cere- brovascular disease. Methods： Clinical data of 48 patients with large-artery atherosclerosis-related ischemic cerebrovascular disease were analyzed retrospectively, including 36 cases presented with TIA, 8 with language dysfunction, 4 with unilateral limb paralysis. EC-IC by- pass was performed according to their clinical symptoms and preoperative imaging features. Based on the improvement of postoperative clinical symptoms and the changes of the postoperative imaging features, the efficacy of EC-IC bypass was assessed. Results： Of the 36 patients with TIA, there was no TIA or stroke event happened in the follow-up period, except 1 patients with complete stroke after EC-IC bypass. The symptoms of the other patients were relieved in six months after treatment, the satisfactory imaging features of the 40 patients after treatment were observed in the follow-up. Conclusion： EC-IC bypass should be effective for the patients with large-artery atherosclerosis-related ischemic cerebrovascular disease, and EC-IC bypass is beneficial in the prevention and treatment of this disease.