摘要目的 报告并评价颌内动脉(MA)与大脑中动脉(MCA)近端搭桥治疗缺血性脑血管病的方法和疗效.方法 对10例缺血性脑血管病患者行桡动脉(RA)移植MA-MCA搭桥术的病例进行回顾性分析,对比手术前后影像学资料的变化,结合术后临床症状改善情况,对这种新的搭桥术式的疗效进行评估.结果 10例患者中,术后CTA和(或)DSA检查示搭桥血管通畅8例;经颅多普勒超声(TCD)检查示搭桥血管通畅1例(出院后3个月行CTA检查示搭桥血管仍通畅);术后未复查1例.所有患者均得到随访,随访时间4-16个月,平均10.3个月,绝大多数患者临床症状有不同程度的改善,1例于术后4个月死亡,没有发现与移植物有关的并发症.结论 RA移植MA-MCA 近端搭桥术是治疗缺血性脑血管病安全有效的方法,与其他术式相比,该术式具有血流量高、移植血管取材短和搭桥路径短等优点,其远期疗效有待于进一步观察.

abstractsObjective To report a new method of the internal maxillary artery(MA)-radial artery (RA)-proximal middle cerebral artery (MCA) bypass surgery for the treatment of ischemic cerebrovascular disease and evaluate the efficacy of the bypass.Methods The clinical data of 10 patients with ischemic cerebrovascular disease were analyzed retrospectively.The new bypass surgery was performed in all cases.Based on the improvement of postoperative clinical symptoms and the changes of the preoperative and postoperative imaging examinations,the safety and efficacy of the new operation were assessed.Results In ten patients,eight MA-RA-MCA bypasses were patent on postoperative CTA and/or DSA.TCD demonstrated a patent anastomosis in one female patient and CTA also revealed this point at her 3-month follow-up.Whether the bypass was patent or not was not clear in one patient because he didn't receive relative examination postoperatively.The ten cases were followed-up with duration from 4 months to 16months (mean,10.3 months).The clinical symptoms of the other 9 patients were upgraded in various degrees except one patient who was dead at the 4th postoperative month.There was no postoperative graft harvest complication.Conclusions The MA-MCA bypass surgery in patients with ischemic cerebrovascular diseases is safe and effective.The bypass could supply high blood flow volume and its bypass path is shorter than other bypass techniques.The long-term efficacy of the bypass should to be further observed and studied.