【摘要】 目的 探讨经颅多普勒超声（transcranial doppler,TCD）对烟雾病（moyamoya disease,MMD）搭桥术疗效评估的有效性。方法 回顾性选取2020年11月—2023年11月青州市人民医院神经外科收治的90例MMD患者，所有患者均接受颞浅动脉-大脑中动脉（superficial temporal artery-middle cerebral artery,STA-MCA）搭桥术且术前术后均行TCD检查。通过TCD检测MCA近心端、远心端的血流参数，包括收缩期峰值流速（peak systolic velocity,PSV）、舒张末期流速（end-diastolic velocity,EDV）、搏动指数（pulsatility index,PI）、阻力指数（resistive index,RI），并依据数字减影血管造影（digital subtraction angiography,DSA）疗效分级评估术后侧支循环形成情况。结果 MCA近心端及MCA远心端术后的PSV、EDV高于术前，MCA近心端及MCA远心端术后的RI、PI低于术前，差异有统计学意义（P<0.05）。不同DSA分级的患者术后PSV、EDV均高于术前，差异有统计学意义（P<0.05），随着DSA分级的升高，术后PSV、EDV也随之增加。不同DSA分级的患者术后PI、PI均低于术前，差异有统计学意义（P<0.05），随着DSA分级的升高，术后PI、RI随之降低。术后并发症发生率为11.11%，其中重型并发症2例，轻型并发症8例。结论 TCD可有效检测MMD搭桥术后血流参数变化，是一种无创、便捷、经济的术后长期随访工具，在MMD搭桥术疗效评估中具有重要应用价值。更多还原

【Abstract】 Objective To explore the effectiveness of transcranial Doppler ultrasound(TCD) in evaluating the therapeutic effect of bypass surgery for Moyamoya disease(MMD). Methods A retrospective analysis was conducted on the clinical data of 90 patients with MMD admitted to the Department of NeuroSurgery of Qingzhou People′s Hospital from November 2020 to November 2023. All patients underwent bypass surgery of the superficial temporal artery-middle cerebral artery(STAMCA) Bypass Surgery and underwent TCD examination before and after the operation. The blood flow parameters at the proximal and distal ends of the MCA were detected by TCD, including peak systolic velocity(PSV), end-diastolic velocity(EDV), pulsatile index(PI), and resistance index(RI), and the formation of collateral circulation after the operation was evaluated based on the efficacy classification of digital subtraction angiography(DSA). Results The PSV and EDV of the proximal and distal ends of the MCA after surgery were higher than those before surgery, while the RI and PI of the proximal and distal ends of the MCA after surgery were lower than those before surgery. The differences were statistically significant(P <0.05). The postoperative PSV and EDV values of patients with different DSA grades were all higher than those before the operation, and the difference was statistically significant(P<0.05). With the increase of DSA grade, the postoperative PSV and EDV values also increased accordingly. The postoperative PI and PI values of patients with different DSA grades were lower than those before the operation, and the difference was statistically significant(P<0.05). With the increase of DSA grade, the postoperative PI and RI values decreased accordingly. The incidence of postoperative complications was 11.11%, including 2 cases of severe complications and 8 cases of mild complications. Conclusion TCD can effectively detect the changes of blood flow parameters after MMD bypass surgery. It is a non-invasive, convenient and economical long-term follow-up tool after surgery and has important application value in the evaluation of the therapeutic effect of MMD bypass surgery.更多还原