颞浅动脉吻合术联合高流量颅内-外血管搭桥术治疗复杂性颅内动脉瘤的疗效

Efficacy of superficial temporal artery anastomosis combined with high flow extracranial-intracranial artery bypass surgery for complex intracranial aneurysms

目的探讨颞浅动脉吻合术联合高流量颅内-外血管搭桥术治疗复杂性颅内动脉瘤患者的临床疗效。方法选取2011年9月至2017年12月间武汉市第九医院收治的39例颅内动脉瘤患者,根据手术方式不同分为观察组(19例)和对照组(20例)。对照组患者采用传统高流量颅内-外血管搭桥术治疗,观察组患者在对照组基础上采用颞浅动脉吻合术,比较两组患者手术前后颞肌厚度、术后感染、张口困难及偏瘫等并发症发生率。结果观察组患者张口困难发生率为5. 3%,低于对照组的35. 0%,差异有统计学意义(P <0. 05)。治疗前,两组患者颞肌厚度比较,差异无统计学意义(P> 0. 05)。治疗后,两组患者颞肌厚度均降低,且对照组低于观察组,差异均有统计学意义(均P <0. 05)。结论颞浅动脉吻合术联合高流量颅内-外血管搭桥术可有效降低复杂性颅内动脉瘤患者术后出现颞肌萎缩几率,促进颞肌血运恢复,操作简便,值得临床推广。

Objective To explore the effect of efficacy of superficial temporal artery anastomosis combined with high flow extracranial-intracranial artery bypass surgery for complex intracranial aneurysms.Methods A total of 39 patients with intracranial aneurysms were selected at Ninth Hospital of Wuhan from September 2011 to December 2017.The patients were divided into an observation group(19 patients)and a control group(20 patients).The observation group underwent superficial temporal artery anastomosis combined with high flow extracranial-intracranial artery bypass surgery and the control group underwent traditional high flow extracranial-intracranial artery bypass surgery.The temporal muscle thickness,incidence of complications such as postoperative infection,month opening difficulty and hemiplegia were recorded and compared between the two groups before and after the operation.Results The incidence of mouth opening difficulty was 5.3%in the observation group,which was significantly lower than 35.0%of the control group(P<0.05).There was no significant difference in the thickness of temporal muscle between the two groups before the treatment(P>0.05).After the treatment,the thickness of temporal muscle decreased in both groups with the control group significantly lower than the observation group(all P<0.05).Conclusion Superficial temporal artery anastomosis combined with high flow extracranial-intracranial artery bypass surgery can effectively reduce the probability of postoperative complications associated with temporal muscle atrophy,and promote the recovery of temporal muscle blood transport in patients with intracranial aneurysms,which is easy to operate and worthy of clinical promotion.