STA-MCA搭桥术在60例闭塞性脑血管病患者治疗中的作用

目的探讨分析STA-MCA搭桥术在闭塞性脑血管病中的治疗作用。方法选取该院2013年5月—2014年5月间收治的闭塞性脑血管病患者60例,所有患者均采用STA-MCA搭桥术进行治疗,同时对手术前、后,所有患者通过脑血管造影和CT脑灌注成像对吻合口通畅情况及脑血流动力学变化进行评价。结果所有患者均手术成功,其中发现20例患者患中,有吻合口处血流通畅者,占手术成功患者数量的69.8%,2例血流缓慢患者,占手术成功患者数量的11.3%,1例患者头皮愈合不良,占手术成功患者数量的6.58%;在手术后造影显示,35例吻合口通畅患者,而CT脑灌注成像则显示,患者脑血流量明显增加,同时相对脑血流平均通过时间明显缩短,差异有统计学意义（P〈0.05）。手术3个月和6个月后,患者神经功能mRS评分较手术前明显降低,差异有统计学意义（P〈0.05）。结论 STA-MCA搭桥术对闭塞性脑血管病有良好的治疗作用,不仅可以增加患侧脑组织的血流,还能够改善患者的神经功能,对同侧脑卒中的发生有一定的预防作用。

The Therapeutic Effect of STA-MCA Bypass in the Treatment of Occlusive Cerebrovascular Disease

Objective To analyze the therapeutic effect of STA-MCA bypass in the treatment of occlusive cerebrovascular disease.Methods 60 cases with occlusive cerebrovascular disease admitted in our hospital from May 2013 to May 2014 were selected and treated by STA-MCA bypass. Before and after the operation, all the patients underwent brain angiography and CT cerebral perfusion imaging for evaluating the anastomotic patency and cerebral hemodynamics changes. Results All the patients underwent the operation successfully. It was found that 20 of the patients had good blood flow at the anastomosis, accounting for 69.8%; 2 cases with slow blood flow, accounted for 11.3%; 1 case with scalp poor healing, accounted for 6.58%. The postoperative brain angiography showed that there were 35 cases with anastomotic patency, and CT cerebral perfusion imaging displayed that the cerebral blood flow in patients increased significantly, and the average relative cerebral blood flow mean transit time shortened, with statistical significance, P〈0.05. 3 months and 6 months after the operation, the mRS neural function score in the patients significantly decreased compared with that before operation, the difference was statistically significant, P〈0.05. Conclusion STA-MCA bypass has a good therapeutic effect on occlusive cerebrovascular disease, which can increase the blood flow in the ipsilateral brain tissue,improve the neurological function of the patients as well as prevent the occurrence of ipsilateral stroke.