颞浅动脉-颞浅筋膜-脑贴敷术治疗烟雾病疗效观察

Curative effect of encephalo-superficial temporal artery-superficial temporal fascia flap-synangiosis on Moyamoya disease(report of 31 cases)

目的：探讨颞浅动脉-颞浅筋膜-脑贴敷术治疗烟雾病的有效性及安全性。方法回顾性分析2005年至2014年运用颞浅动脉-颞浅筋膜-脑贴敷术治疗的31例烟雾病患者的临床资料。结果31例患者共行36侧半球手术，术后随访6~59个月，平均20个月；临床预后优秀或良好26例（83.9%）。22例术后6~45个月（平均17个月）复查脑血管造影，血供重建效果良好12例（54.5%）。术后发生脑梗死、硬膜下血肿及头皮缺血各2例，均未遗留神经功能障碍，只有1例遗留术区头发生长障碍。结论颞浅动脉-颞浅筋膜-脑贴敷术是治疗烟雾病安全、有效的方法。

Objective To evaluate the safety of encephalo-superficial temporal artery （ATA）-superficial temporal fascia flap （STF）-synangiosis and its curative effect on the patients with Momoyaya disease. Method The clinical data of 31 patients with Moyamoya disease, who underwent encephalo-STA-STF-synangiosis from 2005 to 2014, were analyzed retrospectively, including patients＆#39; symptoms and signs, angiographic examination, operative procedure and complications, and prognoses. Results Thirty-six encephalo-STA-STF-synangioses were performed in 31 patients with Momoyaya disease, who were followed up from 6 to 59 months （mean, 20 months）. The rate of good prognosis was 83.9%（26/31）. Twenty-two patients were followed up with DSA from 6 to 45 months （mean, 17 months）, and the rate of good-revascularization was 54.5% （12/22）. There were postoperative complications including the cerebral infarct （2 cases）, subdural hematomas （2 cases） and local scalp ischemia （2 cases） in 6 patients, who had not permanent neurological deficit. There was hair growth-retardation in 1 patient. Conclusion The present results suggest that encehalo-STA-STF-synangiosis is a safe and effective method to treat Momoyaya disease.