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颈动脉体瘤:30年经验

Carotid body tumour: 30 years experience.

作者信息

Dickinson P H, Griffin S M, Guy A J, McNeill I F

出版信息

Br J Surg. 1986 Jan;73(1):14-6. doi: 10.1002/bjs.1800730107.

Abstract

Thirty-two patients with 37 carotid body tumours, seen in the Vascular Unit at the Royal Victoria Infirmary, Newcastle upon Tyne between 1956 and 1985 are reviewed. Twenty-six of the tumours were treated by surgical excision. There were no peri- or postoperative deaths, but one patient developed a permanent hemiplegia following surgery (3.8 per cent); cranial nerve palsy occurred in five patients (19.2 per cent). There were no malignant tumours although in one patient, histology of the resected specimen showed the presence of local lymph node invasion (3.8 per cent). In the 7 patients who did not undergo surgery, 3 have been lost to follow-up; the remainder have not shown any significant increase in the size of the tumour. One patient was treated by radiotherapy. It is concluded that surgical excision is the treatment of choice, though observation may be preferred for the older patient with a symptomless, slow-growing tumour. To help reduce the risk of hemiplegia (the most serious complication of surgery) a meticulous surgical technique is necessary and heparin, intraluminal shunting and facilities for arterial repair and grafting must be at hand.

摘要

回顾了1956年至1985年间在泰恩河畔纽卡斯尔皇家维多利亚医院血管科就诊的32例患者的37个颈动脉体瘤。其中26个肿瘤接受了手术切除。围手术期和术后均无死亡病例,但有1例患者术后出现永久性偏瘫(3.8%);5例患者出现颅神经麻痹(19.2%)。尽管有1例患者切除标本的组织学检查显示存在局部淋巴结浸润(3.8%),但无恶性肿瘤。在未接受手术的7例患者中,3例失访;其余患者肿瘤大小未出现任何显著增加。1例患者接受了放射治疗。结论是手术切除是首选治疗方法,不过对于无症状、生长缓慢的老年患者,观察可能更为可取。为降低偏瘫(手术最严重的并发症)风险,必须采用细致的手术技术,且手边应备有肝素、腔内分流装置以及动脉修复和移植设备。

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