不进行血管重建的颈动脉切除术

不进行血管重建的颈动脉切除术是包括术前颈动脉压迫锻炼与微机脑血流数据测定仪检测脑侧支循环相结合,在锻炼合格的情况下进行肿瘤与受累动脉一并切除的新型术式。本术式自1979年首例成功以来,到1990年共行此术17例(其中15例曾在外院作过1～3次手术),均因病变上界较高,或浸润较广,切除肿瘤及颈动脉后,颈内动脉残端过短,无法进行血管重建。17例术后并发症2例,包括术后健侧肢体活动减弱,1月后完全恢复及术后死于窒息(阻塞性声门水肿)各1例,术后1及3年分别因癌转移及复发死亡各1例,14例2～11年健在,脑供血良好,未出现任何脑血管并发症。

Carotid Resection without Vascular Reconstruction

A new approach doing simple carotid resection which consists of preoperative carotid compression exer- cise and preoperative evaluation of the collateral cerebral crossflow with computerized rheoencephalography was per- formed since 1979. A total of 17 patients underwent this procedure till 1990. All of the lesions were fixed to the carotid artery, and the carotid continuity could not be restored because of the shorthess of the remaining internal carotid stump. Postoperative complications occcurred in 2 patients. One had a transient postoperative cerebrovascular complication from which she recovered within 1 month,and the other patient died with asphyxia resulted from obstructive edema of the glot- tis. Of 17 patiens, 2 died of the malignant lesion, and one died with glottic obstruction, 14 survived for 2-11 years with intact cerebrovascular blood supply.