Abstract: Objective To observe the effect of modified intracranial and extracranial vascular bypass in patients with ischemic cerebrovascular disease.Methods Clinical data of 25 patients with ischemic cerebrovascular disease admitted to our hospital from July 2019 to May 2021 were retrospectively collected.All patients were treated with modified intracranial and extracranial vascular bypass.The patients were observed for 14 d after operation and followed up for 6 months follow-up.The efficacy of all patients 6 months follow-up,the incidence of complications during hospitalization and follow-up were counted,and the parameters of MRI perfusion imaging before and after operation 14 d,as well as scores of mRS and NIHSS before operation,7 d after operation,14 d after operation,at discharge,3 months of follow-up and 6 months of follow-up were counted.Results After 6 months of follow-up,the total effective rate of 25 patients with ischemic cerebrovascular disease treated by modified intracranial and extracranial vascular bypass was 88.00% (22/25).14 d after operation,the cerebral blood flow of patients with ischemic cerebrovascular disease was higher than that before operation (P<0.05),and the mean passage time and peak time of ischemic side were shorter than that before operation (P<0.05).The comparison of mRS score and NIHSS score of patients with ischemic cerebrovascular disease showed 7 d after surgery,14 d after surgery,at discharge,3 months follow-up and 6 months follow-up were lower than before surgery,and there was a decreasing trend at all postoperative time points,and the difference was statistically significant at different time points (P<0.05).In 25 patients with ischemic cerebrovascular disease,There were 1 patients with thin subdural hematoma and 1 patient with local cerebral infarction and 2 patient with hyperperfusion syndrome within 24h after operation.Conclusion Modified intracranial and extracranial vascular bypass for the treatment of patients with ischemic cerebrovascular disease can effectively improve the clinical symptoms and blood perfusion,reduce the occurrence of complications,promote the improvement of patients' neurological function,and has a good therapeutic effect.

Key words: Ischemic cerebrovascular disease, Modified intracranial and extracranial vascular bypass, Neurological function, Vascular imaging

摘要： 目的 观察改良颅内外血管搭桥术治疗缺血性脑血管病患者的疗效。方法 回顾性收集2019年7月~2021年5月我院收治的25例缺血性脑血管病患者临床资料,所有患者均采用改良颅内外血管搭桥术进行治疗,术后观察14 d,出院后随访6个月。统计所有患者随访6个月疗效、住院期间并发症发生情况及随访情况,统计所有患者术前和术后14 d MRI灌注成像参数及术前、术后7 d、术后14 d、出院时及随访3个月、随访6个月mRS评分、NIHSS评分。结果 随访6个月,25例缺血性脑血管病患者经改良颅内外血管搭桥术治疗后总有效率为88.00%(22/25)。术后14 d,缺血性脑血管病患者脑血流量高于术前(P<0.05),平均通过时间、缺血侧达峰时间短于术前(P<0.05)。缺血性脑血管病患者mRS评分、NIHSS评分比较,术后7 d、术后14 d、出院时、随访3个月、随访6个月均低于术前,且术后各时间点呈降低趋势,不同时间点比较,差异具有统计学意义(P<0.05)。住院期间,25例缺血性脑血管病患者术后24 h内发生1例手术部位薄层硬膜下血肿,1例发生局造性脑梗死,2例发生高灌注综合症。结论 改良颅内外血管搭桥术治疗缺血性脑血管病患者,可有效改善患者临床症状及血流灌注情况,降低并发生的发生,促进患者神经功能好转,具有较好的治疗效果。

关键词: 缺血性脑血管病, 改良颅内外血管搭桥术, 神经功能, 血管成像