颈动脉体瘤与颈总动脉分叉处神经源性肿瘤对照研究  

Carotid body tumors and neurogenic tumors at bifurcation of carotid artery:a control study

作　　者：李光鑫[1] 辛世杰[1] 张健[1] 杨栋[1] 丁奎[1] 王雷[1] 李璇[1] 段志泉[1] 

机构地区：[1]中国医科大学附属第一医院普通外科教研室血管甲状腺外科,辽宁沈阳110001

出　　处：《中国实用外科杂志》2012年第12期1023-1026,共4页Chinese Journal of Practical Surgery

摘　　要：目的探讨颈动脉体瘤与颈总动脉分叉处神经源性肿瘤的鉴别要点和手术治疗经验。方法回顾性分析2004年11月至2011年6月中国医科大学附属第一医院手术治疗的颈动脉体瘤16例和颈总动脉分叉处神经源性肿瘤14例的临床资料,对比分析两组的临床表现、影像学资料、手术过程及随访等。结果两组的年龄、性别、既往状况、临床表现差异均无统计学意义,虽然两组的肿瘤大小差异也无统计学意义,但颈动脉体瘤组的手术时间要显著长于神经源性肿瘤组[(119±46)vs.(65±13)min,P<0.05],前者的术中失血量也显著高于后者[(230±127)vs.(89±38)mL,P<0.05]。颈动脉体瘤组手术完整切除肿瘤15例(15/16,93.8%),6例行自体大隐静脉移植、颈内动脉重建术;术后出现轻度舌下神经受损症状1例,出现Horner综合征1例。神经源性肿瘤组14例全部完整切除,均未阻断颈动脉血流;术后出现声音嘶哑1例,Horner综合征3例。两组间并发症发生率的差异无统计学意义(P>0.05),住院时间两组差异亦无统计学意义[(17±7)dvs.(14±5)d,P>0.05]。结论颈动脉体瘤与颈总动脉分叉处神经源性肿瘤的临床表现十分相似,术前确诊有一定困难,手术切除是有效的治疗方法,充分的术前评估及相关准备是手术成功的关键。Abstract Objective To explore the experiences for differential diagnosis and surgical treatment of carotid body tumors and neurogenic tumors at bifurcation of carotid artery. Methods The clinical data of 16 cases of carotid body tumors and 14 cases of neurogenic tumors at bifurcation of carotid artery performed operation between November 2004 and June 2011 in the First Affiliated Hospital of China Medical University were analyzed retrospectively. The clinical manifestations, imaging features, surgical procedures and follow up of the cases were compared. Results There is no statistical difference of age, sex, physical condition, clinical manifestation and size of tumors between two groups. The operating time [ （119＋46）mini and bleeding volume [ （230±127）mL] of the former group were obviously larger than those [ （65 ± 13）min, （89 ± 38）mL] of the later group （P〈0.05）. Fifteen cases of the former group had total tumor resection. Six of them had reconstruction of internal carotid artery using great saphenous vein graft. All cases of the later group had total tumor resection without occluding carotid artery. One case of the former group had minimal damage of hypoglossal nerve. One ease of the former group had Homer syndrome after the operations. One case of the later group had hoarseness. Three cases of the later group had Homer syndrome after the operations. There was no difference in incidence of complication between two groups （P 〉0.05） . The hospital stay of the former group [ （ 17 ±7）d ] was longer than that of the later group [ （ 14±5）d] （P〉0.05）. Conclusion The clinical manifestations of carotid body tumors and neurogenic tumors at bifurcation of carotid artery are similar. It＇s difficult to diagnose exactly before operation. Surgical operation is an available treatment. A clear understanding of the disease and sufficient prepare before operation are keyfactors for successful treatment.

关 键 词：颈动脉体瘤 神经源性肿瘤 外科手术 

分 类 号：R6[医药卫生—外科学]