颅内外动脉搭桥和颞肌贴覆术治疗烟雾综合征的临床分析

›› 2019, Vol. 4 ›› Issue (8): 43-45.

颅内外动脉搭桥和颞肌贴覆术治疗烟雾综合征的临床分析

吴文学1，石凤才1，李强峰1，李兴昌1，李宝成2*

（1.普洱市人民医院神经外科，云南普洱665000；2.瑞丽景成医院神经外科，云南瑞丽678600）

收稿日期:2018-10-18 修回日期:2019-05-12 出版日期:2019-08-15 发布日期:2019-08-15
通讯作者: 李宝成，主任医师，E-mail：894713113@qq.com.
作者简介:吴文学，副主任医师，主要从事颅底神经外科研究.

Clinical Analysis of Intracranial and Extracranial Artery Bypass and Temporal Muscle Attachment
in the Treatment of Moyamoya Syndrome

Wu Wenxue1, Shi Fengcai1, Li Qiangfeng1, Li Xingchang1, Li Baocheng2*

（1. Department of Neurosurgery, People's Hospital of Pu'er City, Pu'er, Yunnan 665000, China; 2. Department of Neurosurgery,
Jingcheng Hospital, Ruili, Yunnan 678600, China）

Received:2018-10-18 Revised:2019-05-12 Online:2019-08-15 Published:2019-08-15

摘要/Abstract

摘要：

目的：探讨颞浅动脉-大脑中动脉搭桥和脑颞肌贴覆术治疗烟雾综合征的临床效果和影响因素。方法：选取普洱市人
民医院2014年至2018年烟雾综合征患者22例，同时影像学提示均合并有脑梗塞病灶，症状表现为不同程度的头晕，肢体功能
障碍。经DSA（数字减影血管造影）确诊存在烟雾血管，在发病7~14 d内行手术治疗，其中9例行颞浅动脉-大脑中动脉搭桥同
时行颞肌贴覆术，13例单纯行颞肌贴覆和硬脑膜血管翻转术。结果：术后6个月回访所有患者脑缺血症状均有所改善，15例肌
力和肢体活动较术前明显好转。DSA检查提示18例患者病变区血管明显增生，颈外动脉造影可见病变区有明显颈外动脉供
血。结论：颞浅动脉-大脑中动脉搭桥和颞肌贴覆术治疗烟雾综合征合并脑梗塞患者安全有效。

关键词: 烟雾综合征, 颞浅动脉-大脑中动脉搭桥, 脑颞肌贴覆术, 脑梗塞

Abstract:

Objective: To explore the clinical effects and influencing factors of superficial temporal arterial-middle cerebral artery
bypass and cerebral temporal muscle attachment in the treatment of moyamoya syndrome. Methods: 22 patients with moyamoya
syndrome in People's Hospital of Pu'er City from 2014 to 2018 were selected. Meanwhile, imaging indications showed that all patients
had cerebral infarction lesions, and the symptoms were varying degrees of dizziness and limb decline. By DSA, the patients were
diagnosed with obvious moyamoya vessels, and underwent surgeries in 7 to 14 days. Among them, 9 cases had superficial temporal
artery-middle cerebral artery bypass and temporal muscle attachment, 13 cases were treated by temporal muscle attachment and dural
vascular inversion. Results: 6 months after the surgeries, all patients' ischemic symptoms improved obviously. Muscle strength and limb
movement were significantly improved in 15 cases. DSA demonstrated vascular hyperplasia was obvious in the lesion area in 18 patients,
and external carotid arteriography showed obvious external carotid artery blood supply in the lesion area. Conclusion: Superficial
temporal artery-middle cerebral artery bypass and temporal muscle attachment are safe and effective in the treatment of patients with
moyamoya syndrome and cerebral infarction.

Key words: moyamoya syndrome, superficial temporal artery-middle cerebral artery bypass, cerebral temporal muscle attachment, cerebral infarction

中图分类号:

R743.3

吴文学, 石凤才, 李强峰, 李兴昌, 李宝成. 颅内外动脉搭桥和颞肌贴覆术治疗烟雾综合征的临床分析[J]. , 2019, 4(8): 43-45.

TUN Wen-Hua, DAN Feng-Cai, LI Jiang-Feng, LI Xin-Chang, LI Bao-Cheng. Clinical Analysis of Intracranial and Extracranial Artery Bypass and Temporal Muscle Attachment
in the Treatment of Moyamoya Syndrome[J]. , 2019, 4(8): 43-45.

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