【摘要】 目的 探讨颞浅动脉-大脑中动脉（STA-MCA）搭桥术联合脑-颞肌贴敷术（EMS）对烟雾病患者认知功能的改善作用。方法 纳入2017年7月至2020年6月在天津医科大学总医院行STA-MCA搭桥术+EMS的37例烟雾病患者，分别于术前1周和术后6个月采用简易智能状态检查量表（MMSE）评估整体认知功能、听觉词汇学习测验（AVLT）评估记忆力、连线测试A(TMT-A)评估注意力、连线测试B(TMT-B)评估执行功能、词语流畅性测验（VFT）评估语言功能、Rey-Osterrieth复杂图形测验（ROCFT）评估视空间能力。结果 与术前1周相比，术后6个月时MMSE[24(23,26)分对25.00(23.50,27.00)分；Z=-4.201,P=0.000]和ROCFT[28(23,30)分对31.00(28.50,32.00)分；Z=-3.968,P=0.004]评分增加，TMT-A[69.00(56.00,87.50)s对42(37,48)s;Z=-5.144,P=0.002]和TMT-B[177(168,190)s对138(133,144)s;Z=-5.309,P=0.001]完成时间缩短；手术前后AVLT-1R(Z=-1.595,P=0.113)、AVLT-5R(Z=-1.573,P=0.121)和VFT(Z=-1.616,P=0.124)评分差异无统计学意义。结论 STA-MCA搭桥术+EMS可以改善烟雾病患者整体认知功能、注意力、执行功能和视空间能力，而对短时记忆、长时记忆和语言功能无明显作用，可以一定程度改善认知功能，提高生活质量。更多还原

【Abstract】 Objective To evaluate the improvement of superficial temporal artery-middle cerebral artery(STA-MCA) bypass combined with encephalo-myo-synangiosis(EMS) on cognitive function in patients with moyamoya disease(MMD).Methods Total 37 patients with MMD treated with STA-MCA+EMS in Tianjin Medical University General Hospital from July 2017 to June 2020 were reviewed.Mini-Mental State Examination(MMSE),Auditory Verbal Learning Test(AVLT),Trail Making Test-A(TMT-A),Trail Making Test-B(TMT-B),Verbal Fluency Test(VFT) and Rey-Osterrieth Complex Figure Test(ROCFT) were used to evaluate overall cognitive function,memory,attention,executive function,language function and visuospatial function in all patients one week before surgery and 6 months after surgery.Results Compared with one week before surgery,the MMSE score [24(23,26) score vs.25.00(23.50,27.00) score;Z=-4.201,P=0.000] and ROCFT score [28(23,30) score vs.31.00(28.50,32.00) score;Z=-3.968,P=0.004] increased,while the TMT-A test [69.00(56.00,87.50) s vs.42(37,48) s;Z=-5.144,P=0.002] and TMT-B test [177(168,190) s vs.138(133,144) s;Z=-5.309,P=0.001] decreased at 6 months after surgery.There was no statistic difference of AVLT-1 R(Z=-1.595,P=0.113),AVLT-5 R(Z=-1.573,P=0.121) and VFT(Z=-1.616,P=0.124) before and after surgery.Conclusions STA-MCA+EMS can improve the overall cognitive function,attention,executive function and visuospatial ability of patients with MMD,but has no significant effect on short-term memory,long-term memory and language function,and can improve cognitive function and the quality of life.更多还原