应用“Bonnet bypass”治疗头颈部巨大恶性肿瘤2例并文献复习  

Treatment of large malignant tumor of head and neck by using“Bonnet bypass”(2 case reports and literature review)

作　　者：袁国艳 吴平安 杨光华 何伟成 张作洪 张振宇 YUAN Guo-yan;WU Ping-an;YANG Guang-hua(Department of Neurosurgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China)

机构地区：[1]香港大学深圳医院神经外科,深圳518000 [2]香港大学深圳医院头颈外科,深圳518000

出　　处：《临床神经外科杂志》2020年第6期708-710,共3页Journal of Clinical Neurosurgery

基　　金：香港大学深圳医院科研培育计划(HKUSZH201901041)。

摘　　要：目的探讨“Bonnet bypass”治疗头颈部巨大恶性肿瘤的可行性,评估治疗效果和临床意义。方法回顾分析采用Bonnet bypass方法治疗的2例头颈部巨大恶性肿瘤晚期患者的临床资料。先用Bonnet bypass方法行对侧颈总动脉-同侧大脑中动脉搭桥手术,二期扩大切除头颈部巨大恶性肿瘤;随访观察患者的预后。并对相关文献进行复习。结果2例患者均顺利完成颈内动脉搭桥及根治性肿瘤切除手术。其中1例患者术后4个月肿瘤复发,6个月后搭桥血管闭塞,21个月后因肿瘤进展死亡;另1例患者术后5个月搭桥血管闭塞,12个月肿瘤复发,16个月后因肿瘤进展死亡。结论应用“Bonnet bypass”治疗颈部巨大恶性肿瘤,分期行血管重建和根治性肿瘤切除可以很好地控制局部病变,提高生存质量。Objective To evaluate the efficacy and clinical significance of Bonnet bypass in the treatment of large head and neck malignancies.Methods The clinical data and follow-up results of two patients with advanced head and neck tumor who underwent by using Bonnet Bypass,that was cerebral revascularization of contralateral common carotid artery(CCA)-ipsilateral middle cerebral artery(MCA)Bypass surgery,were analyzed retrospectively.The relevant literatures were reviewed.Results The extracranial-intracranial bypass and aggressive tumor resection were completed successfully in both patients.1 patient with malignant tumor recurred 4 months after surgery,graft was occluded 6 months after surgery,and died due to cancer-related causes 21 months later.Another patient with malignant tumor recurred 12 months after surgery,graft was occluded 5 months after surgery,and died due to cancer-related causes 16 months later.Conclusion The use of“Bonnet bypass”in the treatment of large malignant tumor of head and neck,staging vascular reconstruction and aggressive resection can improve the locoregional control rate and quality of patient survival.

关 键 词：Bonnet血管搭桥术 头颈部巨大恶性肿瘤 大隐静脉 

分 类 号：R739.41[医药卫生—肿瘤]