头颈肿瘤术后并发颈动脉破裂4例报告

目的：探讨头颈部恶性肿瘤侵犯颈动脉的手术治疗方法。方法：对4例颈动脉与转移瘤粘连患者，采用从颈动脉壁上剥离切除肿瘤保留血管的术式。结果：术后1周内4例都发生了颈动脉破裂，1例经颈动脉修补术后再发血管破裂出血死亡，3例经行颈动脉结扎术后存活。结论：对于肿瘤累及颈动脉的患者术前应作好结扎切除颈动脉的准备；术中若发现肿瘤与血管壁粘连，则应结扎血管连同肿瘤一并切除；一旦术后并发颈动脉破裂，则应结扎之，而不宜行修补术。

Postoperative rupture of carotid artery in head and neck neoplasms

Objective:To explore the treatment of neoplasms in head and neck invaded the carotid artery.Method:Four cases with postoperative rupture of carotid artery invaded by the head and neck cancer were reviewed. The tumours were taken off from the carotid arteries and the carotid artery remained.Result:Rupture of carotid artery occurred in 4 patients within one week after radical neck dissection. One patient died because of its rupture again after repair.The other three survived after ligating the artery.Conclusion:The carotid artery involved by tumour of head and neck should be prepared for resection before operation.If the artery was obviously invaded by the tumour, both the tumour and artery should be resected together.Once the rupture of the artery occurred after operation,the artery must be ligated instead of being repaired.