超选择动脉预栓塞对不同体积和Shamblin分型的颈动脉体瘤切除术的影响  

The Effects of Preoperative Transarterial Embolization on Carotid Body Tumor Surgeryof Different Volumes and Shamblin Types

作　　者：徐涛 李楠 杨建勇[3] 黄勇慧[3] XU Tao;LI Nan;YANG Jianyong(Department of Interventional Radiology,Shenzhen People's Hospital,The Second Clinical Medical College,Jinan University,The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,Guangdong Province 518020,P.R.China)

机构地区：[1]深圳市人民医院介入科,暨南大学第二临床医学院,南方科技大学第一附属医院,518020 [2]广州市第一人民医院,华南理工大学附属第二医院,510180 [3]中山大学附属第一医院放射介入科,广州510080

出　　处：《临床放射学杂志》2022年第3期551-557,共7页Journal of Clinical Radiology

基　　金：广东省自然科学基金项目(编号:2020A1515010920)。

摘　　要：目的探讨超选择动脉预栓塞(p-TAE)对不同体积和Shamblin分型颈动脉体瘤(CBTs)外科切除术的影响。方法回顾性搜集CBTs患者为研究对象,根据是否行p-TAE术将其分为两组:栓塞组(EG)和未栓塞组(NEG)。搜集、分析并比较两组患者基本资料、手术方式、出血量、外科手术时间、术中血管重建率以及并发症发生率等相关指标。结果共纳入107例患者(115个病灶),其中EG病灶86个,NEG病灶29个。EG与NEG肿瘤体积分别为:Ⅰ型:1177.50 mm^(3)vs.1910.17 mm^(3),P>0.05;Ⅱ型:22141.48mm^(3)vs.16514.14 mm^(3),P>0.05;Ⅲ型:48015.83mm^(3)vs.72494.75 mm^(3),P>0.05。术中出血量以及手术时间分别为:Ⅰ型:15.00 ml vs.19.17 ml,P>0.05;Ⅱ型:171.60 ml vs.190.79 ml,P>0.05;Ⅲ型:662.50 ml vs.1150.00 ml,P>0.05、Ⅰ型:37.50 min vs.110.00 min,P<0.05;Ⅱ型:198.24 min vs.227.63 min,P>0.05;Ⅲ型:283.92 min vs.332.75 min,P>0.05。p-TAE术在一定程度上降低Ⅱ/Ⅲ型CBTs术中血管重建率(Ⅱ型:15.28%vs.15.79%,P>0.05;Ⅲ型:50%vs.75%,P>0.05)和外科手术相关并发症(Ⅰ型:0%vs.33.33%,P>0.05;Ⅱ型:26.39%vs.47.37%,P>0.05;Ⅲ型:41.67%vs.50%,P>0.05)。结论术前栓塞可降低不同类型Shamblin CBTs术中失血量倾向,改善手术视野可视化,缩短手术时间,有利于CBTs的手术切除,并减少术中血管重建可能及降低手术并发症。Objective To investigate the effect of superselective transarterial embolization(p-TAE)on surgical resection of carotid body tumors(CBTs)of different tumor volumes and Shamblin types.Methods This retrospective study reviewed 115 tumors in107 patients from Jan 2011 to April 2020,which underwent surgical resection for CBTs.The CBTs were divided into the embolization group(EG)and non-embolization group(NEG)according to whether to carry out the p-TAE.The clinical features,imaging examination,treatment strategy,and the operative and post-operative information about the patients were retrieved from the patient records.Results The average tumor volumeswere(Ⅰ:1177.50 mm^(3)vs.1910.17mm^(3);Ⅱ:22141.48 mm^(3)vs.16514.14 mm^(3);Ⅲ:48015.83 mm^(3)vs.72494.75 mm^(3),allP>0.05)for EG and NEG.The mean surgical time(Ⅰ:37.50 min vs.110.00 min,P<0.05;Ⅱ:198.24 min vs.227.63 min,P>0.05;Ⅲ:283.92 min vs.332.75 min,P>0.05)and intraoperative blood loss(Ⅰ:15.00 ml vs.19.17 ml,P>0.05;Ⅱ:171.60 ml vs.190.79ml,P>0.05;Ⅲ:662.50 ml vs.1150.00 ml,P>0.05)were less in the EG patients when compared to NEG.The incidence of revascularization required(Ⅱ:15.28%vs.15.79%;Ⅲ:50.00%vs.75.00%,allP>0.05)and total complications(Ⅰ:0%vs.33.33%,P>0.05;Ⅱ:26.39%vs.47.37%,P>0.05;Ⅲ:41.67%vs.50.00%,P>0.05)were lower in the EG when compared to NEG.Conclusion Surgical resection of CBTs is safe and reliable with a need for p-TAE.P-TAE can reduce bloodloss,shorten operative time,and decrease the incidence of adverse events and revascularization to some extent.Furthermore,the larger the tumor volumes,the greater the surgical benefit of p-TAE.

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

分 类 号：R739.91[医药卫生—肿瘤]