颅内外血管架桥术治疗缺血性脑血管病疗效的再评价

目的 对颅内外血管架桥术治疗缺血性脑血管病的疗效进行再评价。 方法 对30例经正规内科治疗后仍有颈内动脉系统缺血症状的患者,进行了颞浅动脉-大脑中动脉吻合术,并对术后患者的脑血流改善情况及临床情况进行了分析。 结果 术前患者均为一过性缺血发作神经性缺损(TIA),可逆性缺血性神经障碍(RIND)和不典型脑缺血症状,术前CT,MRI检查无大面积脑梗死,SPECT·rCBF均有脑血流减低区。术后血管造影显示吻合口通畅率为86.7％,术后局部脑血流改善率为70％,随访仅发现2例患者有2次TIA,无完全性卒中发生,术前有轻度神经功能障碍的8例患者,术后均有不同程度的恢复。 结论颞浅动脉-大脑中动脉吻合术可预防颈内动脉系统血流动力学障碍性脑缺血发展成完全性卒中。

Re-valuation of the effect on extra-intracranial bypass for ischemic cerebrovascular disease

Objective To re-valuate the effect of EC-IC bypass surgery on ischemic cerebrovascular disease. Methods The clinical and follow-up data of 30 patients with STA-MCA bypass surgery were analyzed retrospectively. Results The patients' symptoms before surgery were TIA, RIND and atypical cerebral ischemic syndrome. There was no large size of cerebral infarction on CT and MRI, there were regional cerebral blood flow reduced area before surgery on SPECT ?rCBF. The patency rate of bypass surgery was 86. 7% verified by postoperative angiography, and the rate of improved regional cerebral blood flow was 70% postoperatively. There were 2 attacks of TIA in 2 patients and no complete stroke occurred during follow-up. The moderate neurological deficits before EC-IC bypass surgery in 8 patients were recovered partly during follow-up. Conclusion STA-MCA bypass surgery may effect to prevent complete stroke due to hemodynamic cerebral ischemia.