术前经导管动脉栓塞对ShamblinⅡ/Ⅲ型颈动脉体瘤切除术的影响  

Beneficial Effects of Preoperative Embolization on the Shamblin TypeⅡ/ⅢCarotid Body Tumor Surgery

作　　者：孔祥国[1] 李楠[2] 杨建勇[2] 黄勇慧[2] KONG Xiang-guo;LI Nan;YANG Jian-yong;HUANG Yong-hui(Department of Radiology,Linyi People’s Hospital,Linyi,260000;Department of Interventional Radiology,The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]临沂市人民医院放射科,山东临沂276000 [2]中山大学附属第一医院放射介入科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2021年第2期287-293,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广州市科技计划项目(202002030084)。

摘　　要：【目的】探讨术前经导管动脉栓塞(Pre-TAE)对Ⅱ/Ⅲ型颈动脉体瘤(CBTs)外科切除术的影响。【方法】回顾性分析2010年1月至2020年1月我院收治的影像及病理确诊的Ⅱ/Ⅲ型CBTs患者为研究对象,根据是否行Pre-TAE将患者分为栓塞组及未栓塞组。分析并比较两组患者临床资料、手术方式、术中出血量、手术时间、并发症等相关指标。【结果】本研究共纳入100个病灶(栓塞组n=77,未栓塞组n=23)。栓塞组与未栓塞组肿瘤大小分别为(Ⅱ:40.91 vs.37.32 mm,P>0.05;Ⅲ:63.58 vs.65.75 mm,P>0.05)。术中出血量以及手术时间分别为(Ⅱ:100 vs.100 mL,P>0.05;Ⅲ:750 vs.1000 mL,P>0.05)、(Ⅱ:184.66 vs.230.74 mins,P>0.05;Ⅲ:288.50 vs.332.75 mins,P>0.05)。尽管Pre-TAE能减少Ⅱ/Ⅲ型CBTs术中血管重建率(Ⅱ:28%vs.32%,P>0.05;Ⅲ:58%vs.100%,P>0.05),但其差异无统计学意义。Ⅱ/Ⅲ型CBTs栓塞组手术并发症明显低于未栓塞组,其差异无统计学意义(Ⅱ:22%vs.47%,P=0.026;Ⅲ:50%vs.75%,P>0.05)。【结论】术前栓塞CBTs可有效降低术中失血量,改善手术视野可视化,从而有利于ShamblinⅡ/Ⅲ级CBTs的手术切除,减少手术时间,减少术中血管重建可能及手术并发症。【Objective】To investigate the feasibility and efficacy of preoperative arterial embolization(Pre-TAE)onⅡ/Ⅲcarotid body tumors(CBTs)surgical resection.【Methods】This retrospective study reviewed 100 cases of CBTs in the First Affiliated Hospital,Sun Yat-sen University from Jan 2010 to Jan 2020,which underwent surgical resection for CBTs.According to whether receiving the pre-TAE,the patients were classified into the embolization group(EG)and non-embolization group(NEG).Tumor classification was performed as the Shamblin classification.The demographic,clinical features,and the operative and post-operative information about the patients were retrieved from the patient re⁃cords【.Results】The average tumor sizes were(Ⅱ:40.91 vs.37.32 mm,P>0.05;Ⅲ:63.58 vs.65.75 mm,P>0.05)for EG and NEG.The mean operative time(Ⅱ:184.66 vs.230.74 mins,P>0.05;Ⅲ:288.50 vs.332.75 mins,P>0.05)and intraoperative blood loss(Ⅱ:100 vs.100 mL,P>0.05;Ⅲ:750 vs.1000 mL,P>0.05)were less in the EG pa⁃tients.The incidence of revascularization required(Ⅱ:28%vs.32%,P>0.05;Ⅲ:58%vs.100%,P>0.05)and total complications(Ⅱ:22%vs.47%,P=0.026;Ⅲ:50%vs.75%,P>0.05)were lower in the EG when compared with NEG.【Conclusions】CBTs can be surgically resected safely and effectively with a need for pre-TAE.Resection patients who received pre-TAE had lower blood loss and shorter duration of operation.The rates of adverse events,revasculariza⁃tion were also lower for patients who had pre-TAE compared to those who did not.The larger the tumor size,the greater the surgical benefit of pre-TAE.

关 键 词：颈动脉体瘤 术前经导管动脉栓塞 Shamblin分级 外科手术切除 

分 类 号：R657.4[医药卫生—外科学]