外科手术治疗颈动脉体瘤的临床研究

目的:回顾性总结分析颈动脉体瘤(CBT)诊断,手术治疗及并发症防治的经验与教训。方法:对安徽省立医院口腔颌面头颈外科1990年2月～2010年1月收治的27例CBT进行回顾性分析和研究,全部病例术前均经影像学证实(B超,DSA和CTA)。采用颈动脉体瘤钝性剥离式切除11例,颈动脉体瘤与颈外动脉合并切除5例,颈动脉体瘤剥离式切除和颈内动脉部分切除6例,颈动脉体瘤剥离式切除和颈总动脉结扎5例。结果:术后均经病理证实为颈动脉体瘤,且无恶变。无围手术期死亡,有3例在术后16～24h内出现偏瘫,3～4d后逐渐好转,并分别于16、22和47d后恢复正常,肌张力达到Ⅱ级以上,经平均随访5年以上,除1例死于2年以后的脑卒中外余均无瘤生存。结论:术前选择性影像学检查以明确诊断,并根据肿瘤与颈动脉的关系选择适当方案尽早手术治疗。

Clinical Study of Surgical Treatment for Carotid Body Tumor

Objective: To analyze retrospectively experience and lessons about diagnosis,surgical treatment and complications prevention of 27 cases of carotid body tumor(CBT).Methods: Analyzed and studied retrospectively 27 cases were treated by oral and maxillofacial head and neck surgery of Anhui Provincial Hospital from February 1990 to January 2010,and all patients were preoperatively confirmed by imaging(B ultrasonic,DSA and CTA).Using a carotid body tumor blunt dissection type resection for 11 cases,carotid body tumor and external carotid artery merger resection for 5 cases,carotid body tumor dissection type resection and internal carotid artery partial resection for 6 cases,and carotid body tumor dissection type resection and common carotid artery ligation for 5 cases.Results: All the cases were pathologically proved for carotid body tumor,and had no malignant transformation.No perioperative death happened,hemiplegia occured in 3 patients within 16-24h after surgery,3-4d improves gradually,and recovered to normal after respectively 16,22 and 47d.Muscle tension achieved above level.Except 1 cases died of stroke after two years,others are tumor-free survival by the average follow-up more than 5 years.Conclusion: We should confirm the diagnosis by preoperative selective imaging,and select the appropriate surgical program as soon as possible according to the relationship between the tumor and carotid artery.