支架植入治疗颈动脉体瘤术后继发假性动脉瘤的临床分析  

Interventional treatment with stent graft implantation of pseudoaneurysm following blunt dissection of carotid body tumors

作　　者：周斌[1] 庄秀妹[1] 陈伟良[1] 王友元[1] 张大明[1] 范松[1] 黄志权[1] 

机构地区：[1]中山大学孙逸仙纪念医院口腔颌面外科,广东广州510120

出　　处：《中国口腔颌面外科杂志》2015年第3期253-257,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:评价手术治疗颈动脉体瘤和支架植入治疗切除术后继发假性动脉瘤的临床疗效。方法:6例颈动脉体瘤患者按Shamblin分级分别为I级1例、II级1例和III级4例,肿瘤大小为2 cm×3 cm^5 cm×6 cm(平均3.7 cm×4.7 cm)。其中直接手术切除颈动脉体瘤2例,手术切除颈动脉体瘤并结扎颈外动脉2例,颈总动脉-颈内动脉人造血管重建2例。结果:所有患者均未出现围术期死亡及卒中,出血量为250~650 m L(平均455 m L)。2例患者术后出现假性动脉瘤和声带麻痹,经介入引导下血管支架植入和药物治疗后症状完全消失。随诊6~17个月,未发现肿瘤复发及严重并发症。结论:手术治疗颈动脉体瘤效果良好、安全可靠;直接手术切除可能继发假性动脉瘤,而介入引导下血管支架植入具有良好的治疗效果。PURPOSE： To evaluate the clinical effect of surgical treatment of carotid body tumor and interventional treatment with stent graft implantation of pseudoaneurysms following blunt dissection of the tumor treated. METHODS：Six cases were classified as Shamblin Ⅰ, Ⅱ and Ⅲ in 1, 1, and 4 cases, respectively. The tumor sizes varied from a minimum of 2 cm×3 cm to a maximum of 5 cm× 6 cm（median： 3.7 cm×4.7 cm）. Two of them underwent blunt dissection of carotid body tumor, two underwent blunt dissection and ligation of external carotid artery of carotid body tumor and 2 had common carotid artery-internal carotid artery artificial vascular reconstruction. RESULTS： No perioperative mortality and stroke occurred. The range of mean blood loss was 455 m L（range, 250-650 m L）. Two patients had pseudoaneurysm or vocal cord paralysis postoperatively and both recovered with stent graft implantation and medical treatment respectively.The patients were followed up for 6-17 months, no recurrence was seen at the follow-up period. CONCLUSIONS：Surgical treatment of carotid body tumor is acceptably safe and effective according Shamblin classification;Pseudoaneurysms following blunt dissection of the tumor can occur and using a stent graft was feasible for treating the lesion.

关 键 词：颈动脉体瘤 颈动脉重建 Shamblin分类 假性动脉瘤 

分 类 号：R739.91[医药卫生—肿瘤]