选择性血管栓塞术辅助颈动脉体瘤切除术  

Selective embolization for surgical treatment of carotid body tumor

作　　者：胡敏[1] 张立海[2] 杨舸[1] 陈丽洁[1] 湛雄[3] 

机构地区：[1]中国人民解放军总医院口腔科,北京100853 [2]中国人民解放军总医院骨科,北京100853 [3]中国人民解放军空军总医院口腔科,北京100142

出　　处：《华西口腔医学杂志》2010年第4期387-390,共4页West China Journal of Stomatology

摘　　要：目的观察颈动脉造影及选择性血管栓塞术对颈动脉体瘤切除术的影响。方法选择7例颈动脉体瘤患者为研究对象,其中4例于手术前行颈动脉造影及选择性血管栓塞术,其余3例不行血管栓塞术。7例患者均行手术治疗,均采取剥离肿瘤与颈动脉的术式,比较术前行选择性血管栓塞与否的治疗效果。结果 7例患者的颈动脉体瘤均为ShamblinⅢ型,CT以及三维重建影像能清楚显示肿瘤及其与周围动脉的关系。所有病例均完整切除肿瘤而未结扎颈内、颈外动脉,术后均无严重并发症发生。4例术前行选择性血管栓塞术的患者术中出血量平均为160mL,手术时间平均为2.5h;3例未行血管栓塞术患者的术中出血量平均为600mL,手术时间平均为4h。术后随访1.5～3年,7例患者均无复发。结论颈动脉体瘤术前行颈动脉造影和选择性血管栓塞术可以有效减少术中出血,有助于降低手术的风险。Objective To investigate the value of carotid arteriography and selective embolization in surgical treatment of carotid body tumor.Methods Seven patients with carotid body tumor were operated,and four patients were performed with carotid arteriography and selective embolization before operation.All patients were treated by stripping the carotid body tumor from the carotid artery.Treatment effectiveness of the patients with and without selective embolization were compared.Results Seven cases were classified as Shamblin Ⅲ type.The CT scan and digital subtraction angiography（DSA） showed the tumor lesion in the carotid bifurcation,and the tumor and its relation with the surrounding arteries were expressed by CT and three dimensional CT images.All cases of carotid body tumor were resected without any carotid artery ligation.No serious complications occurred after operation.There was average 160 mL blood loss in operation of four patients that had angiograms and were preoperatively embolized,and average 2.5 h were expended.There was average 600 mL blood loss in operation of three patients without preoperatively embolized,and average 4 h were expended.Preoperatively high-selected embolization of the tumor-feeding artery could effectively reduce the intraoperative bleeding.With 1.5-3 years follow-up,none of the carotid body tumor recurred in all the seven cases.Conclusion Carotid arteriography and embolization therapy may decrease blood loss and higher risk for operation in the patients with carotid body tumor.

关 键 词：颈动脉体瘤 数字减影血管造影 栓塞 

分 类 号：R739.91[医药卫生—肿瘤]