颅外颈动脉瘤的诊断和治疗  

Diagnosis and management of extracranial carotid artery aneurysms

作　　者：郁正亚[1] 刘昌伟[1] 管珩[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院血管外科,100730

出　　处：《中华普通外科杂志》1998年第5期262-264,共3页Chinese Journal of General Surgery

摘　　要：目的探讨颅外颈动脉瘤的诊断和治疗方法。方法对12例颅外颈动脉瘤的治疗进行回顾性总结。结果颈总动脉瘤9例、颈内动脉瘤3例,均经手术治疗。其中动脉瘤切除、颈内动脉重建术11例;动脉瘤包裹术1例。术中未用内转流。手术并发症1例,无手术死亡。术后随访8个月至10年,远期效果良好。结论动脉硬化和动脉壁变性是本病的主要病因。术前 Matas 试验及术中颈内动脉返回压的测定十分重要,如果 Matas 试验可以耐受15～20分钟的颈动脉阻断或术中测量颈内动脉返回压大于4.9kPa(50mmHg),可以不用内转流。手术原则是切除动脉瘤,恢复颈内动脉的连续性。Objective The purpose of this study was to approach the diagnosis and management of extracranial carotid artery aneurysms.Methods A retrospective analysis was performed on 12 cases operated for extracranial carotid artery aneurysms in PUMC Hospital from 1983 to 1997.Patients' follow up was obtained from 8 months to 10 years. Results There were nine common carotid artery aneurysms and three internal carotid aneurysms.All patients under- went operation with no motality and operative complication rate was 8.3%.Operative techniques included aneurysm excision and internal carotid artery reanastomosis(11 cases,91.7%)or wrapping up aneurysm with PTFE graft(1 case,8.3%).Intraluminal shunt was not applied.Nine patients has been followed up from 8 months to 10 years and healthy.The comnon causes of extracranial carotid artery aneurysm were atherosclerosis and artery wall dysplasia or degeneration.Conclusion The operative principle of the disease is aneurysmectomy and reconstructing the continuity of internal carotid artery.A thorough physical examination should be performed before operation,especially extracranial carotid artery system.Preoperative Matas test and determining retrograde stump pressure of internal carotid artery,dur- ing operation was very important.If the time of Matas test is more than 15～20 min or retrograde stump pressure is higher than 50 mmHg,shunt could be saved.

关 键 词：颈外动脉瘤 颈动脉瘤 脑血管重建术 诊断 

分 类 号：R739.91[医药卫生—肿瘤] R732.21[医药卫生—临床医学]