接受标准化多学科治疗的咽喉癌患者颈动脉和锁骨下动脉破裂综合征的治疗结果
Outcome of carotid and subclavian blowout syndrome in patients with pharynx- and larynx carcinoma passing a standardized multidisciplinary treatment.
作者信息
Gahleitner Constanze, Hofauer Benedikt, Storck Katharina, Knopf Andreas
机构信息
a Department of Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar , Technische Universität München , München , Germany.
出版信息
Acta Otolaryngol. 2018 May;138(5):507-512. doi: 10.1080/00016489.2017.1419575. Epub 2018 Jan 8.
BACKGROUND
Carotid blowout syndrome (CBS) is one of the most feared emergencies in the head and neck surgery and tends to occur in patients with head and neck cancer, wound complications, pharyngocutaneous fistulas, or after radio(chemo)therapy. CBS is always life threatening and associated with a 50% mortality/morbidity rate.
METHODS
Between 2007 and 2015, a total of 51 patients who developed CBS caused by the tumour masses or after radio(chemo)therapy were included. All patients underwent a standardised bleeding management.
RESULTS
In 86% of patients, CBS was associated with manifest carcinoma. Fifty three percent of patients were treated by transcervical surgery, in 36% of these cases surgery was supplemented by endovascular approaches. Severe complications such as re-bleeding or cerebral ischemia occurred infrequently. Seven patients died because of the acute bleeding.
CONCLUSION
CBS associated with head and neck cancer carries poor mid and long-term prognoses. An interdisciplinary standardised treatment path dramatically reduced overall morbidity and mortality.
背景
颈动脉破裂综合征（CBS）是头颈外科最可怕的急症之一，往往发生于患有头颈癌、伤口并发症、咽皮肤瘘或接受放（化）疗后的患者。CBS始终危及生命，且死亡率/发病率达50%。
方法
2007年至2015年期间，共纳入51例因肿瘤肿块或放（化）疗后发生CBS的患者。所有患者均接受标准化出血管理。
结果
86%的患者CBS与明显的癌症有关。53%的患者接受了经颈手术治疗，其中36%的病例手术辅以血管内治疗方法。严重并发症如再次出血或脑缺血很少发生。7例患者因急性出血死亡。
结论
与头颈癌相关的CBS预后不良。跨学科标准化治疗路径显著降低了总体发病率和死亡率。
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