侵及颈总动脉病变的手术治疗  

Surgery for lesions involved the carotid artery

作　　者：谷京城[1] 徐艳萍[2] 司忠义[3] 隋瑾辉[1] 王雪峰[1] 邢巍巍[1] 康健[1] 崔颖[1] 孙旭云[1] 柴丽[1] 陈冬[1] 王锐[1] 刘永新[1] 宫亮[1] 马晓峰[1] 陈鲁赞[1] 郭飞飞[1] 

机构地区：[1]辽宁医学院附属第一医院耳鼻咽喉头颈外科,辽宁锦州121001 [2]吉林大学第二医院耳鼻咽喉科,吉林长春130041 [3]辽宁医学院附属第一医院心脏血管外科,辽宁锦州121001

出　　处：《中国耳鼻咽喉头颈外科》2009年第9期472-475,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：辽宁省卫生厅医学科技创新工程和重点学科建设项目(2D06-12-15)

摘　　要：目的探讨侵及颈总动脉病变的手术方法及注意事项。方法分析11例资料完整的患者资料,包括喉癌喉3/4切除术后复发1例,结核性颈总动脉瘤破裂大出血1例,医源性颈总动脉瘤1例,颈动脉体瘤3例,甲状腺癌侵及颈总动脉1例,颈部肿瘤侵及颈总动脉2例,颈总动脉离断伤1例,气性坏疽1例。结果上述病例中,2例完成肿瘤切除,颈总动脉重建;2例术中应用Shunt转流管,完成肿瘤切除;1例颈外伤,行颈总动脉结扎;1例医源性颈总动脉瘤患者,行动脉瘤切除,颈总动脉修补;甲状腺癌患者分离颈总动脉并切除部分气管侧壁完成肿瘤切除及应用颈前肌气管修补;2例颈部肿瘤保留颈总动脉切除肿瘤;1例气性坏疽患者颈部切开减压。结论侵及颈总动脉病变的手术治疗,主要有下列3种形式:①切除肿瘤及颈总动脉、颈动脉重建;②切除肿瘤及颈总动脉,颈总动脉结扎;③分离颈总动脉切除肿瘤。OBJECTIVE To investigate the surgical methods for the lesions involved the common carotid artery.METHODS The clinical data of 11 cases with lesions involved the common carotid artery who underwent operations were retrospectively studied.The lesions were 1 case with recurrence tumor after 3/4 partial laryngectomy,1 case with bleeding of the carotid aneurysm caused by tuberculosis,1 case with iatrogenic carotid aneurysm,3 cases with carotid body tumor,1 case with thyroid gland cancer,2 cases with neck tumor,1 case with injury of the carotid artery and 1 case with gas gangrene.RESULTS Common carotid artery was reconstructed in 2 cases after removal of the tumors.The tumors were resected using the carotid shunt in 2 cases.Common carotid artery was sutured in 1 case with neck injury.The common carotid artery was repaired in 1 case with iatrogenic carotid aneurysm after removal of the tumor.The carotid artery was dissected out from the thyroid gland cancer in 1 case.The common carotid artery was reserved in 2 cases after resection of the neck tumors. Neck drainage was performed in the case with gas gangrene.CONCLUSION The surgical methods for lesions involved the carotid artery after removal of the tumors include the reconstruction of the carotid artery, resection and suture the carotid artery,and free of the carotid artery from the tumors.

关 键 词：颈总动脉 肿瘤侵润 头颈部肿瘤 外科手术 

分 类 号：R762[医药卫生—耳鼻咽喉科]