80例颈动脉体瘤的外科治疗  

Surgical treatment of carotid body tumor in 80 patients

作　　者：朱江[1] 魏小龙[1] 秦锋[1] 赵志青[1] 景在平[1] 

机构地区：[1]上海第二军医大学附属长海医院血管外科,200433

出　　处：《中华普通外科杂志》2017年第2期126-128,共3页Chinese Journal of General Surgery

基　　金：国家自然科学基金会资助项目（81170299）

摘　　要：目的探讨颈动脉体瘤（carotid body tumor，CBT）的诊断、术前检查和手术治疗的经验。方法回顾性分析2008年12月至2014年12月第二军医大学附属长海医院行手术切除的80例CBT患者的临床特点、手术方式及预后情况。其中，男33例，女47例，患者平均年龄（434-12）岁。单侧CBT68例，双侧CBT12例。92个瘤体均行手术切除，26个Shamblin Ⅰ型瘤体、32个Shamblin Ⅱ型瘤体和19个Shamblin Ⅲ型瘤体行单纯肿瘤切除；1个Shamblin Ⅱ型瘤体和2个Shamblin Ⅲ型瘤体行肿瘤切除联合颈外动脉栓塞：3个Shamblin Ⅱ型瘤体和8个Shamblin Ⅲ型瘤体行肿瘤切除联合颈内动脉重建；1个Shamblin Ⅲ型瘤体行肿瘤切除联合颈内动脉修补。结果92个瘤体均成功切除。围手术期无死亡病例，术后偏瘫1例，颅神经损伤14例。随访68例，随访率为85％，随访时间1～6年。平均随访（2．9±1．4）年。14例颅神经损伤患者，2例失访，11例部分或完全恢复，1例未恢复。结论瘤体大小及瘤体与颈动脉的关系是选择手术方式的依据。选择合适的手术方式早期切除瘤体是颈动脉体瘤的治疗关键。Objective To investigate the diagnosis, preoperative examination and surgical treatment of carotid body tumor（CBT）. Methods From December 2008 to December 2012 80 patients of carotid body tumor were treated in our center. The average age was（43 ±12）years, 33 cases were male, 47 cases were female. The lesions were unilateral in 68 cases and bilateral in 12. All tumors were surgically resected. In 26 of Shamblin Ⅰ , 32 of Shamblin Ⅱ and 19 of Shamblin m tumors were simply resected. One Shamblin Ⅱ and 2 Shamblin m cases underwent tumor resection combined with external carotid embolization. 3 Shamblin Ⅱ and 8 Shamblin Ⅲ cases were treated by tumor resection combined with internal carotid reconstruction, 1 Shamblin Ⅲ was done with tumor resection combined internal carotid repair. Results All of 80 patients with 92 tumors were successfully resected. There was no death case during peroperative period, while one case developed hemiplegia and 14 cases suffered cranial nerve injuries. 68 cases （85%） were followed-up from 1 year to 6 years. Thera were 14 patients with cranial nerve injuries, 2 of them were lost to follow-up, 11 with complete or partial recovery and 1 was still doing poorly. Conclusions Tumor size and its relation to the carotid artery form the basis upon which appropriate operation is adopted.

关 键 词：颈动脉体瘤 外科手术 手术后并发症 

分 类 号：R654.3[医药卫生—外科学]