超声刀辅助颈动脉体瘤切除术的疗效观察  

Observation on the effect of ultrasonic scalpel-assisted carotid body tumor resection

作　　者：闻荻豪 孙羽东 李昱 朱江 王诗颖 魏小龙 赵志青 吴雅妮 Wen Dihao;Sun Yudong;Li Yu;Zhu Jiang;Wang Shiying;Wei Xiaolong;Zhao Zhiqing;Wu Ya'ni(Department of Vascular Surgery,the First Affiliated Hospital of PLA Naval Medical University,Shanghai 200433,China;Department of Nail Breast Surgery,the First Affiliated Hospital of PLA Naval Medical University,Shanghai 200433,China)

机构地区：[1]解放军海军军医大学第一附属医院血管外科,上海200433 [2]解放军海军军医大学第一附属医院甲乳外科,上海200433

出　　处：《血管与腔内血管外科杂志》2021年第6期670-674,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨超声刀辅助颈动脉体瘤(CBT)切除术的疗效。方法收集2015年5月至2020年5月在解放军海军军医大学第一附属医院接受CBT手术的96例患者临床资料。按照治疗方法不同分为超声刀辅助组(n=40)和常规手术组(n=56)。统计并比较两组患者的手术情况(术中出血量、手术时长、术中血管重建情况和住院时间)和不良事件(短暂性颅神经损伤、永久性颅神经损伤和脑梗死)。统计两组shamblin分型为Ⅲ型患者的术中出血量、并发症和不良事件。结果超声刀辅助组患者手术时间及住院时间短于常规手术组患者,术中出血量少于常规手术组患者,短暂性及永久性颅神经损伤发生率低于常规手术组患者,差异有统计学意义(P<0.05);两组患者术中血管重建率比较,差异无统计学意义(P>0.05)。超声刀辅助组shamblin分型为Ⅲ型患者的术中出血量低于常规手术组shamblin分型为Ⅲ型患者,短暂性及永久性颅神经损伤发生率均低于常规手术组shamblin分型为Ⅲ型患者,差异有统计学意义(P<0.05)。结论超声刀辅助CBT能显著减少术中出血量,缩短手术时间,减少并发症的发生。Objective To explore the effect of ultrasonic scalpel-assisted carotid body tumor(CBT)resection.Method The clinical data of 96 patients who underwent CBT surgery in the First Affiliated Hospital of PLA Naval Military Medical University from May 2015 to May 2020 were collected.According to different treatment regimens,the subjects were divided into an ultrasonic dissector-assisted group(n=40)and a conventional surgery group(n=56).Statistics and comparison of the surgical conditions(intraoperative blood loss,operation duration,intraoperative vascular reconstruction,and hospital stay)and adverse events(transient cranial nerve injury,permanent cranial nerve injury,and cerebral infarction)of the two groups of patients were conducted.The intraoperative blood loss,complications,and adverse events of the two groups of shamblin type III patients were counted.Result The operation time and hospital stay in the ultrasonic scalpel-assisted group was shorter than those in the conventional operation group,the volume of intraoperative blood loss was less than that in the conventional operation group,and the incidence of transient and permanent nerve injury was lower than that in the conventional operation group.The difference was statistically significant(P<0.05).There was no significant difference in the intraoperative vascular reconstruction rate between the two groups of patients(P>0.05).The intraoperative blood loss of patients with shamblin type III in the ultrasonic scalpel-assisted group was lower than that of patients with shamblin type III in the conventional surgery group.The incidence of transient and permanent nerve injury was lower than that in the conventional surgery group with shamblin type III.The difference was statistically significant(P<0.05).Conclusion The ultrasonic scalpel-assisted group could remarkably reduce the volume of intraoperative blood loss,shorten the operation time and reduce the incidence of complications.

关 键 词：颈动脉体瘤 超声刀 出血 神经损伤 

分 类 号：R543[医药卫生—心血管疾病]