颈动脉体瘤切除术后发生颅神经损伤的危险因素分析  

Analysis of risk factors for cranial nerve injury after carotid body tumor resection

作　　者：阿布都西库尔·阿布都米吉提 艾孜江·艾买提 吴源泉[1] Abuduxikuer·Abudumijiti;Aizijiang·Aimaiti;Wu Yuanquan(Department of Hepatobiliary Vascular Surgery,First People's Hospital of Kashgar Prefecture,Xinjiang Uygur Autonomous Region,Kashgar 844000,Xinjiang,China;Department of General Surgery,First People's Hospital of Kashgar Prefecture,Xinjiang Uygur Autonomous Region,Kashgar 844000,Xinjiang,China)

机构地区：[1]新疆维吾尔自治区喀什地区第一人民医院肝胆血管外科,新疆喀什844000 [2]新疆维吾尔自治区喀什地区第一人民医院普通外科,新疆喀什844000

出　　处：《血管与腔内血管外科杂志》2023年第9期1071-1075,共5页Journal of Vascular and Endovascular Surgery

基　　金：自治区科技支疆项目(2021E02081)。

摘　　要：目的探讨颈动脉体瘤(CBT)切除术后发生颅神经损伤(CNI)的危险因素。方法收集2015年1月至2020年12月于新疆维吾尔自治区喀什地区第一人民医院就诊的238例行CBT切除术患者的临床资料,按照CBT切除术后CNI发生情况将其分为CNI组(n=57)和非CNI组(n=181)。记录所有患者的一般资料、影像学检查结果、实验室指标结果、临床特征、手术情况以及随访结果,分析CBT切除术后发生CNI的危险因素。结果两组患者Shamblin分型、颈外动脉结扎、高位病变、淋巴结切除数目、手术时间、失血量、术后住院时间、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、中性粒细胞/淋巴细胞比值(NLR)比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,ShamblinⅢ型、高位病变、颈外动脉结扎、淋巴结切除数目多、失血量﹥1000 ml均是CBT切除术后发生CNI的独立危险因素(P﹤0.05)。结论Shamblin分型较高、高位病变、颈外动脉结扎、淋巴结切除数目较多、术中失血量较多均是CBT切除术后发生CNI的危险因素,临床上应针对上述高危因素人群采取预防措施。Objective To analyze the risk factors of postoperative cranial nerve injury(CNI)after carotid body tumor(CBT)resection.Method The clinical data of 238 patients who underwent CBT resection in the First People's Hospital of Kashgar Prefecture,Xinjiang Uygur Autonomous Region from January 2015 to December 2020 were collected.According to occurrence of CNI after surgery,the patients were divided into CNI group(n=57)and non CNI group(n=181).The general data,imaging examination and laboratory results,clinical features,surgical conditions and follow-up results of all patients were recorded,and the risk factors of CNI after CBT resection were analyzed.Result There were significant differences for Shamblin type,external carotid artery ligation,high lesion,number of lymph nodes removed,operation time,blood loss,postoperative hospitalization time,levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and neutrophils lymphocytes ratio(NLR)in two groups(P<0.05).Multivariate logistic regression analysis showed that Shamblin type III,high lesion,external carotid artery ligation,number of lymph nodes removed,and blood loss>1000 ml were independent risk factors for CNI after CBT resection(P<0.05).Conclusion Higher Shamblin type,high lesion,external carotid artery ligation,more lymph nodes removed,and higher blood loss are risk factors for CNI after CBT resection.Preventive measures should be taken for the population with high-risk factors.

关 键 词：颈动脉体瘤切除术 颅神经损伤 并发症 危险因素 

分 类 号：R543[医药卫生—心血管疾病]