摘要
目的探讨围手术期血流动力学管理在烟雾病脑血流重建术治疗中的作用。方法回顾性分析安徽省立医院自2014年3月至2018年7月同一术者收治的连续96例烟雾病病人,所有的病人均行颞肌贴敷-硬脑膜翻转-颞浅动脉-大脑中动脉吻合术,围手术期接受血流动力学管理。结果共行117侧手术,其中21例病人行双侧脑血流重建术,75例病人行单侧手术。统计分析脑血流重建术后14 d内的并发症发生率,其中92(78.6%)侧术后顺利恢复,未见急性期相关并发症,余25(21.4%)侧脑血流重建术后出现相关并发症。其中高灌注综合征17(14.5%)例,缺血型并发症3(2.59%)例,癫痫1(0.86%)例,切口愈合不良3(2.59%)例,1(0.86%)例病人高灌注综合征合并切口愈合不良。结论对于烟雾病脑血流重建术,加强围手术期血流动力学管理可降低缺血型并发症的发生率。
Objective To explore the role of perioperative hemodynamic management in the revascularization for moyamoya disease.Methods A retrospective analysis was made of consecutive 96 patients with moyamoya disease treated by the same surgeon in Anhui Provincial Hospital from March 2014 to July 2018.All patients underwent temporalis muscle patching-dural turnover-superficial temporal artery-middle cerebral artery anastomosis and received prospective hemodynamic management during perioperative period.Results There were 117 operations were performed.Postoperative complications within 14 days after revascularization were examined.Among them 92(78.6%)patients recovered were discharged successfully after operation and there were no complications in the acute stage.Postoperative complications were observed in the remaining 25(21.4%)operations after revascularization,including hyperperfusion syndrome in 17(14.5%)cases,ischemic complications in 3(2.59%)cases,epilepsy in 1(0.86%)case,poor wound healing in 3(2.59%)cases,and hyperperfusion syndrome with poor wound healing in 1(0.86%)case.Conclusion For the revascularization in moyamoya disease,strengthening perioperative hemodynamic management can reduce the incidence of ischemic complications effectively.
作者
李昌文
张楠
李冬雪
高歌
朱余友
胡伟
牛朝诗
夏成雨
LI Changwen;ZHANG Nan;LI Dongxue;GAO Ge;ZHU Yuyou;HU Wei;NIU Chaoshi;XIA Chengyu(Department of Neurosurgery,Anhui Provincial Hospital Affiliated to Anhui Medical University,The First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China;Department of Neurology,Anhui Provincial Hospital Affiliated to Anhui Medical University,The First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China)
出处
《安徽医药》
CAS
2020年第6期1147-1150,共4页
Anhui Medical and Pharmaceutical Journal
基金
安徽省2017年公益性技术应用研究联动计划项目(1704f0804015)
安徽省2018年度重点研究与开发计划项目(1804h08020250)。
