探讨颞浅动脉跨区供血的反流轴型耳后岛状皮瓣在修复面部缺损中的应用。方法:根据颞浅动脉的解剖分布及其与耳后动脉的吻合特点,制备以颞浅动脉供血的耳后岛状皮瓣,经皮下隧道转移至受区,修复面部缺损。结果:本组19例患者,17例全部存活,皮瓣的形态、色泽及功能良好。2例早期出现静脉回流障碍,积极处理后,皮瓣远端仅有小部分表皮坏死。结论:颞浅动脉跨区供血的反流轴型耳后岛状皮瓣修复面部缺损,是比较理想的修复方式。

Objective To investigate the application of reversal flow axial retroauricular island flap based on the superficial temporal artery for facial defect. Methods According to the anatomical distribution of the superficial temporal artery and the anastomosis characteristics between posterior auricular artery and superficial temporal artery,we manufactured retroauricular island flap nourished by superficial temporal artery to repair facial defect via a subcutaneous tunnel. Results Among seventeen out of nineteen patients in this group,the transplanted skin flap survived and their shape、color and function were well.Two cases with venous reflux disorders in early stage was treated actively,only a small portion of the distal skin necrosised. Conclusion Reversal flow axial retroauricular island flap based on the superficial temporal artery is an ideal repairing way for facial defect.

目的 探讨颞浅动脉-大脑中动脉吻合术治疗烟雾病的疗效、手术要点及术后并发症.方法 28例接受颞浅动脉-大脑中动脉吻合术的烟雾病患者,对其手术前后的临床资料进行回顾分析.结果 28例患者均手术成功,术后复查DSA或CTA示吻合口通畅良好,颅脑CT灌注成像示脑灌注较术前明显改善.随访4 ～48个月,无脑梗死及脑出血患者,3例患者出现短暂性脑缺血发作(TIA),但发作次数及持续时间较术前均明显减少.结论 颞浅动脉-大脑中动脉吻合术治疗烟雾病短期内安全有效,但其长期效果有待进一步研究.

Objective To evaluate the therapeutic effect of superficial temporal artery-middle cerebral artery(STA-MCA) bypass in the treatment of Moyamoya disease.Methods From April 2009 to June 2013,STAMCA bypass operatioas were performed in 28 patients (15 females/13 males,age 6-49 years) with Moyamoya disease.The frontal and parital branches of the superficial temporal artery were separated under the microscope,then anastomosed with the M3 or M4 segment of middle cerebral artery.All clinical and radiological data were retrospectively reviewed.Results All of the operations were successful.Postoperative CT angiography or DSA imaging demonstrated patency of the bypass in all patients.CT perfusion obviously demonstrated improvement of cerebral perfusion.The ischemic symptoms were relieved in most of the patients.3 patients suffered transient ischemic attack (TIA).In 4 patients,the incision showed small amount of exudate and wound healing delayed.During the follow-up period,no cerebral homorrhage o

目的 观察颞浅动脉-大脑中动脉分支吻合术联合脑-硬脑膜-肌肉血管融合术在缺血型烟雾病中的治疗作用.方法 回顾分析2009年3月至2011年12月在我院接受颞浅动脉-大脑中动脉分支吻合术联合脑-硬脑膜-肌肉血管融合术治疗的21例缺血型烟雾病患者的临床资料.其中5例接受同侧颞浅动脉-大脑中动脉2支血管吻合,16例接受同侧颞浅动脉-大脑中动脉单支吻合.结果 21例患者术中荧光造影显示吻合口全部通畅.16例术后1周内复查了CT血管成像,5例复查全脑数字减影血管造影术,其中20例显示吻合血管通畅,l例吻合血管闭塞.21例缺血型患者中有10例患者的运动或感觉障碍等症状在术后第2天即有明显改善.1例失语患者症状消失,4例头晕,4例头痛患者症状减轻.有2例患者临床症状较术前无明显改变.结论 应用直接联合间接血管重建术能明显改善缺血型烟雾病患者缺血症状.

Objective To evaluate the therapeutic effect of superficial temporal artery-middle cerebral artery(STA-MCA) anastomosis combinined with original encephaloduromyosynangiosis in the treatment of Ischemictype moyamoya disease.Methods All 21 patients with ischemic-type moyamoya disease admitted to our hospital from March 2009 to December 2011 were reviewed.Results Fluorescence angiography showed anastomotic patency in all 21 patients.One week after operation,16 case had CT angiography,5 cases had digital subtraction angiography.Twenty cases showed the anastomosis patency and 1 cases had anastomosis vascular occlusion.10 cases with motor or sensory disorder and other symptoms on the second postoperative day had significant improvement.One case of aphasia was cured.Four cases of dizziness and four headache patients had improvement.Two cases with preoperative symptoms had no obvious changes.Conclusion STA-MCA anastomosis combinined with original encephaloduromyosynangiosis seem to be effectiv

目的探讨颞浅动脉-大脑中动脉搭桥手术在缺血性脑血管病中的治疗应用及CT脑灌注成像对术前、术后脑血流量及手术效果的评价。方法选择2012年2月至2013年6月在山西医科大学第一医院神经外科进行颞浅动脉-大脑中动脉搭桥术的18例患者,脑血管造影或CT脑血管成像提示单侧血管闭塞或严重狭窄;术前行脑CT灌注成像,通过评估感兴趣区内相关指标,明确是否存在血流动力学改变。对脑血流动力学结果和临床表现进行综合评价,按照严格的纳入、排除标准选取患者进行颞浅动脉-大脑中动脉搭桥手术。术后复查脑血管造影或CT血管成像以及CT灌注成像,通过测量术后相关指标,与术前进行比较,评估手术患者的血管吻合口状况及血流动力学情况。应用美国国立卫生研究院卒中量表(NIHSS)对患者进行随访,评估患者手术前、后神经功能状况。所有收集的数据使用SPSS 13.0统计软件进行分析。结果 18例搭桥手术均顺利完成,术后CT灌注成像显示患侧脑血流量明显较术前升高(t=-6.443,P0.05),平均通过时间明显减少(t=6.270,P0.05),峰值时间也减少(t=3.574,P0.05)。术后12周随访NIHSS评分较术前下降(t=3.310,P0.05),神经功能症状有明显缓解。结论颞浅动脉-大脑中动脉搭桥术通过增加手术侧的脑血流量,可以在短

Objective To explore the therapeutic application of superficial temporal artery-middle cerebral artery( STA-MCA) bypass operation in ischemic cerebrovascular diseases and the value of cerebral CT perfusion imaging ( CTP) on evaluation of preoperative and postoperative cerebral blood flow and surgical results.Methods Eighteen patients undergone STA-MCA bypass surgery in Department of Neurosurgery of the First Hospital of Shanxi Medical University ,from February 2012 to June 2013 were enrolled in this study , with their digital subtraction angiography ( DSA) or CT angiography ( CTA) results showing unilateral vascular occlusion or severe stenosis .CTP was carried out preoperatively to verify whether hemodynamic changes exist or not.After the evaluation of the results of cerebral hemodynamics and clinical manifestations ,patients were selected for STA-MCA bypass operation strictly according to inclusion and exclusion criteria .CTP and DSA or CTA were performed postoperatively .C

对标本库头面部颢侧血管走行异常的男性成人标本进行非测量性考察。发现左侧颞浅静脉与其伴行的动脉分支呈缠绕交织型走向变异，已明显形成扭曲性挤压。耳颞神经未发现明显异常。

The specimens library head facial line blood vessels in the temporal of male adult specimens with non -measurement.Founding on the left side of the temporal superficial vein and its concomitant arterial branches in winding mixed type to mutate,has obvious distortion of compress,auriculotemporal nerve does not found obvious abnormality.