介入手段覆膜支架治疗头颈肿瘤术后颈动脉破裂的临床研究  

Application of covered stent in treatment of carotid blowout after head and neck tumors resection

作　　者：张大明[1] 杨朝晖[1] 许林锋[2] 王友元[1] 梁启祥[1] 林钊宇[1] 陈伟良[1] 

机构地区：[1]中山大学孙逸仙纪念医院口腔颌面-头颈外科,广东广州510120 [2]中山大学孙逸仙纪念医院放射介入科,广东广州510120

出　　处：《中国耳鼻咽喉头颈外科》2016年第7期389-391,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的：评价头颈部肿瘤术后颈动脉破裂的介入手段覆膜支架植入治疗的可靠性。方法5例头颈肿瘤术后颈动脉破裂患者，男4例，女1例，年龄47～72岁，平均58.4岁。复发口腔、口咽癌3例（均有放化疗病史），颈动脉体瘤1例，鼻咽癌放疗后上颌复发疣状癌1例。在介入室全麻或局麻下行覆膜支架置入术。结果全部病例成功置入覆膜支架。颈动脉破裂处完全闭塞，术后病程平稳，未出现神经系统并发症。随访时间2～36个月，2例死于肿瘤再复发，3例生存良好。结论介入手段覆膜支架置入治疗头颈肿瘤术后颈动脉破裂快速、安全、有效。OBJECTIVE To assess the treatment reliability of covered stent for carotid artery blowout after head and neck tumors resection. METHODS Five cases with postoperative rupture of carotid artery invaded by the head and neck tumor were reviewed. They presented with life threatening massive neck or oral bleedings. All of them were treated with self expanding covered stents through intervention therapy approach. RESULTS The covered stent were successfully deployed in the target arteries in all cases,the instant isolation effect was quite satisfactory. After treatment, angiography showed successful occlusion of the pseudoaneurysm, patency of carotid artery lumen, and significant improvement of clinical symptoms without neurologic dysfunction. Following up 2 to 36 months, 3 patients were alive with no disease, two patients died of recurrence. CONCLUSION For the treatment of carotid blowout, endovascular occlusion with covered stent is a minimally-invasive, safe and reliable methods.

关 键 词：颈内动脉破裂 头颈部肿瘤 覆膜支架 介入治疗 

分 类 号：R739.91[医药卫生—肿瘤]