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作 者:徐荣伟[1] 叶志东[1] 樊雪强[1] 张建彬[1] 王谦[1] 刘鹏[1]
出 处:《中华全科医师杂志》2015年第10期778-781,共4页Chinese Journal of General Practitioners
基 金:科技部国家国际科技合作专项项目(2013DFA31900)
摘 要:回顾性分析21例颈动脉体瘤(CBT)患者的临床资料。所有患者术前均经影像学检查诊断,单侧病变20例,双侧病变1例。20例行手术治疗,其中11例行单纯瘤体切除,6例行瘤体连同颈外动脉切除,3例行瘤体切除并血管重建。围手术期无手术死亡病例,术后出现颅神经损伤表现5例。术后病理学检查均诊断为CBT,其中1例为恶性。随访3个月-7年,随访率为85%。5例颅神经损伤者均于随访3个月后完全恢复,1例双侧病变于术后1年在外院行对侧瘤体切除,1例恶性肿瘤术后3年因多发转移死亡,其余病例均无复发。CBT临床易误诊,术前超声、数字减影血管造影(DSA)、CT血管造影(CTA)或磁共振血管造影(MRA)等对诊断和手术安全性评估有重要意义。手术切除是治疗CBT的首选和有效方法。The clinical data of 21 patients with carotid body tumor (CBT) were analyzed retrospectively. The lesions were unilateral (n = 20) and bilateral ( n = 1 ). Among 20 surgical cases, the procedures included tumor resection alone ( n = 11 ), tumor resection along with external carotid artery (n = 6) and vascular reconstruction of carotid artery after resection of tumor body ( n = 3 ). No mortality occurred during perioperative period. CBT was confirmed by pathologic examination in all cases and 1 case was malignant. Follow-up period ranged from 3 months to 7 years and the follow-up rate was 85%. Five cases of cranial nerve impairment recovered completely over 3 months. One case of bilateral CBT underwent contralateral tumor resection at another hospital 1 year later and 1 case with malignant tumor died from metastases 3 years later. The remainder survived recurrence-free. CBT tends to be misdiagnosed. Therefore ultrasonography, digital subtraction angiography (DSA), CT angiography (CTA) or magnetic resonance angiography (MRA) are important for preoperative diagnosis and evaluation. Surgical resection is a first choice for CBT.
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