颈根部肿瘤的外科治疗  

Surgery treatment of root of the neck tumor

作　　者：李桂荣[1] 李随勤[2] 

机构地区：[1]西安医学院第二附属医院耳鼻咽喉科,陕西西安710038 [2]西安交通大学第一附属医院耳鼻咽喉-头颈外科,陕西西安710061

出　　处：《海南医学院学报》2011年第10期1377-1379,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020110377)~~

摘　　要：目的:探讨颈根部的界定、临床应用解剖、手术进路,分析颈根部治疗中可能存在的问题。方法:回顾性分析36例颈根部肿瘤手术患者临床资料,良性肿瘤10例,恶性肿瘤26例,根据病变范围及性质采取了T形及L形切口,必要时劈开胸骨,切除部分胸骨柄及胸锁关节。结果:10例良性肿瘤完整切除,随访5年以上4例,3年以上4例,1年以上2例,均未复发;2例出现合并症,乳糜漏1例,喉返神经损伤1例。26例恶性肿瘤,存活5年者3例,3年者10例,2年者5例,1年者1例,余7例均在术后1年内死亡;恶性肿瘤中锁骨下静脉破裂2例,臂丛神经损伤3例,纵膈气肿1例,膈神经损伤1例,术腔血肿2例。结论:加强颈根部应用解剖、手术进路及术中注意问题的研究,可提高颈根部肿瘤的诊治水平,改善患者生存质量。Objective： Explore the root of the neck to define the clinical application of anatomy,surgical approaches.Analysis of possible problems with the treatment.Methods： A retrospective analysis of March 2000 to 2010 made in April of 36 patients with cervical root of the tumors,including benign in 10 cases,malignant in 26 cases.The scope and nature of the lesion to the T-shaped and L-shaped incision,if necessary,split the sternum,resection of part of the sternum and sternoclavicular joints.Results：Complete resection of benign tumors,4 cases followed for 5 years,3 years in 4 cases,more than 1 year in 2 cases.2 patients had complications,chylous leakage in 1 case,recurrent laryngeal nerve injury in 1 case.26 cases of malignant tumors,5 cases survived 5 years,3 years,4 cases,2 years in 10 cases,Remaining 7 patients died within 1 year after surgery,cancer in two cases of rupture of the subclavian vein,brachial plexus injury in 3 cases of mediastinal emphysema in 2 cases,1 case of phrenic nerve injury,hematoma cavity.Conclusions： The roots of 36 patients with cervical cancer surgical treatment and results analysis,the root of the neck to improve on the traditional understanding of tumor surgery.

关 键 词：颈根部肿瘤 应用解剖 手术入路 

分 类 号：R739.91[医药卫生—肿瘤] R730.5[医药卫生—临床医学]