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[供血血管术前栓塞后颈动脉体瘤的手术治疗经验]

[Experience of surgical treatment of carotid body tumor after preoperative embolization of feeding vessels].

作者信息

Li Song-qi, Ye Cai-sheng, Hu Zuo-jun, Lin Yong-jie, Li Xiao-xi, Lü Wei-ming, Wang Shen-ming

机构信息

Department of Vascular Surgery, First Affiliated Hospital of Sun Yet-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Apr 7;89(13):894-7.

Abstract

OBJECTIVE

To evaluate the effect of preoperative embolization of the feeding vessels of carotid body tumor in the treatment thereof.

METHODS

33 patients with carotid body tumors not less than 3 cm in diameter were examined by color Doppler ultrasound. Polyvinyl alcohol particle 250-1000 microm in diameter were suspended in meglumine diatrizoate or Ultravist and then injected via microcatheter into the feeding vessels until detainment or reflux was seen. Operation was performed 1 day later on 23 patients and 4 days later on 10 patients. External carotid artery to internal carotid artery bypass was performed on 1 case, anastomosis of common carotid to internal carotid artery with auto-saphenous vein interposition on 3 cases, and repair of internal carotid artery on 1 case.

RESULTS

One-stage resection was completed on all tumors. One case suffered contralateral hemiplegia two times in the operative day, on the next day the contralateral lower limb could move, but the patient could not speak clearly and his tongue was not in right position, after 3 months he was completely recovered and MRI illustrated cranial infarction.

CONCLUSION

An important adjunct in treating large carotid body tumor, preoperative embolization makes the surgical exploration proceed much smoother, blood loss become less, and morbidity lower.

摘要

目的

评估术前栓塞颈动脉体瘤供血血管在其治疗中的效果。

方法

对33例直径不小于3 cm的颈动脉体瘤患者进行彩色多普勒超声检查。将直径为250 - 1000微米的聚乙烯醇颗粒悬浮于葡甲胺泛影葡胺或优维显中,然后通过微导管注入供血血管,直至出现滞留或反流。23例患者在1天后进行手术,10例患者在4天后进行手术。1例行颈外动脉至颈内动脉搭桥术,3例行自体大隐静脉移植颈总动脉至颈内动脉吻合术,1例行颈内动脉修复术。

结果

所有肿瘤均完成一期切除。1例患者在手术当天出现两次对侧偏瘫,次日对侧下肢可活动,但患者不能清晰说话且舌位不正,3个月后完全恢复,MRI显示颅内梗死。

结论

术前栓塞是治疗大型颈动脉体瘤的重要辅助手段,可使手术探查更顺利,减少出血,降低并发症发生率。

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