恶性颈动脉体瘤的外科治疗  

Surgical treatment of malignant carotid body tumor

作　　者：顾光超 刘志丽[1] 刘暴[1] 刘昌伟[1] 叶炜[1] 陈跃鑫[1] 倪冷[1] 曾嵘[1] 邵江[1] 宋小军[1] 郑月宏[1] Gu Guangchao;Liu Zhili;Liu Bao;Liu Changwei;Ye Wei;Chen Yuexin;Ni Leng;Zeng Rong;Shao Jiang;Song Xiaojun;Zheng Yuehong(Department of Vascular Surgery,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]北京协和医院血管外科,100730

出　　处：《中华普通外科杂志》2020年第3期183-186,共4页Chinese Journal of General Surgery

摘　　要：目的总结恶性颈动脉体瘤(malignant carotid body tumor,MCBT)的外科治疗经验。方法回顾性分析2005年3月至2019年11月协和医院收治的14例MCBT患者,收集患者的影像资料、手术记录、围手术期并发症和随访资料。结果患者男8例,女6例,年龄(40.8±11.3)岁。10例患者行手术切除MCBT,包括单纯肿瘤剥除1例,切除肿瘤合并颈内动脉重建9例,患者术中均行颈部淋巴结活检。术中出血(955±658.5)ml,围手术期无死亡或脑梗发生。术后4例患者出现永久性神经损伤。随访时间1~132个月,随访期间无脑梗或死亡病例,桥血管均保持通畅。2例患者在随访期间发生肿瘤转移,其余患者病情稳定无进展。结论手术仍是MCBT的主要治疗方式,但MCBT体积大,Shamblin分型高,因而完整切除肿瘤和重建颈动脉难度大。手术应力求完整切除肿瘤,并行颈部淋巴结活检以明确淋巴结转移情况。Objective To summarize the surgical treatment of malignant carotid body tumor(MCBT).Methods A retrospective analysis of 14 MCBT patients admitted at our hospital from Mar 2005 to Nov 2019 was made,and the imaging data,surgical records,perioperative complications and follow-up data were collected.Results There were 8 males and 6 females,with an average age of(40.8±11.3)years.10 patients underwent surgical resection of CBT,with one case undergoing tumor enucleation only,nine cases underwent internal carotid artery reconstruction,and all patients underwent intraoperative lymph node biopsy.Tumors were completely removed in all 10 patients.No perioperative death or cerebral infarction occurred.The intraoperative blood loss was(955±658.5)ml.Four patients had permanent nerve injury after surgery.The follow-up time ranged 1-132 months.There were no cases of cerebral infarction or death,and the reconstructed graft remained patent.Apart from the 2 patients who developed tumor metastasis after surgery,other patients recovered uneventfully with no disease progression.Conclusions Surgery is still the main treatment for MCBT,but MCBT is large and Shamblin class is more advanced.Therefore,complete tumor removal and reconstruction of the carotid arteries are difficult.Surgery should seek to completely remove the tumor and neck lymph node biopsy should be performed to determine the lymph node metastasis.

关 键 词：颈动脉体瘤 血管外科手术 

分 类 号：R73[医药卫生—肿瘤]