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[颈动脉体瘤的诊断与外科治疗以及血管假体的作用]

[Diagnosis and surgical management of carotid body tumor as well as blood vessel prosthesis' role].

作者信息

Ye Ping, Pan Xin-liang, Liu Da-yu, Lei Da-peng, Cai Xiao-lan

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital, Shandong University, Jinan 250012, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006 Dec;41(12):919-23.

PMID:17345705
Abstract

OBJECTIVE

To analyse the diagnostic and therapeutic aspects of carotid body tumor (CBT).

METHODS

Seven patients with CBT had been hospitalized between 2003 and 2006. The clinical data was analyzed retrospectively. The preoperative evaluation included angiography in 7 patients. Most of them had an asymptomatic cervical lateral mass. Only one patient had the hoarseness and buckling and was given radiation therapy alone. Six of seven patients with carotid body tumour underwent surgery. Simple tumor excision was accomplished in 4. Carotid artery resection with the tumor was required in 2 patients and in the both, interposition of a 7 mm polytetrafluoroethylene graft was performed . During the resection, temporary carotid shunt was required in the two patients.

RESULTS

All tumors by surgery were identified as carotid paragangliomas without evidence of malignancy. There was no mortality and no hemiplegia. After surgery, temporary cranial nerve dysfunction was noted in one case. In the follow-up period of 2 months to 2 years, no recurrent disease occurred. The patient's tumor who accepted radiotherapy was in the stable stage under the half year follow up, and the follow up would be further continued.

CONCLUSIONS

With non-invasive investigation and arteriography it was possible to obtain an early and precise diagnosis. The surgical management was the major treatment of these tumors. The pattern of operation should be chosen according to the relation of tumor and carotid. The decision to perform simple tumor excision or additional arterial resection was based on diagnostic preoperative and after the arterial resection the polytetrafluoroethylene graft would be used for carotid reconstruction.

摘要

目的

分析颈动脉体瘤(CBT)的诊断与治疗方法。

方法

2003年至2006年间收治7例CBT患者,对其临床资料进行回顾性分析。7例患者术前均行血管造影检查。多数患者表现为无症状性颈部肿块,仅1例患者伴有声音嘶哑及吞咽困难,仅接受了放射治疗。7例颈动脉体瘤患者中6例接受了手术治疗。4例行单纯肿瘤切除术,2例患者需行肿瘤与颈动脉一并切除,术中均采用7mm聚四氟乙烯人工血管行血管重建。术中2例患者需使用临时颈动脉分流管。

结果

所有手术切除的肿瘤均确诊为颈动脉副神经节瘤,无恶性证据。无手术死亡及偏瘫发生。术后1例患者出现短暂性脑神经功能障碍。随访2个月至2年,无复发。接受放疗患者的肿瘤在半年随访期内病情稳定,将继续随访。

结论

通过无创检查及动脉造影可实现早期精确诊断。手术治疗是这些肿瘤的主要治疗方法。手术方式应根据肿瘤与颈动脉的关系选择。单纯肿瘤切除或加行动脉切除的决策应基于术前诊断,动脉切除后应用聚四氟乙烯人工血管重建颈动脉。

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