包裹型颈动脉体瘤手术严重并发症救治

目的总结颈动脉体瘤手术并发症的救治经验。方法对12例(13侧)包裹型颈动脉体瘤病例治疗过程中的并发症进行回顾性临床分析。结果 4例术中颈动脉分叉处破裂,迷走神经部分切除1例,单侧舌咽、迷走、舌下神经损伤2例,其中1例伴发癫痫,双侧舌咽、迷走、舌下神经严重损伤1例,无偏瘫、死亡病例。结论充分理解颈动脉体瘤生长方式,术中娴熟的手术操作,是彻底切除肿瘤,保全动脉血管完整性,避免脑缺血的关键所在,但术后神经损伤的严重并发症切勿忽视。

Management of serious complications in treatment of encapsulated carotid body tumor

Objective To sum up the experience in the management of serious postoperative complications of encapsulated carotid body tumor(CBT).Methods We performed retrospective clinical analysis on the management of serious complications in 12 patients with encapsulated CBT on 13 sides in surgical treatment.Results Among the 12 cases,rupture of the middle carotid at the branching spots occurred to 4 patients intraoperatively,partial vagus nerve resection to 1,nerve injury of unilateral glossopharyngeal,vagus and hypoglossal to 2,one of whom companied with epilepsy,and severe injury of bilateral glossopharyngeal,vagus and hypoglossal occured to 1,but neither hemiplegy nor death happened to any of the cases.Conclusions The key to the complete removal of the tumor with the carotid intact and prevention of cerebral ischemia in CBT patients lies in a good insight into the growing mode of CBT and adept surgical skills.Postoperative complications of nervous injury should never be neglected.