颈部神经鞘瘤的外科治疗  

Surgical treatment of cervical schwannoma

作　　者：顾光超 向文轩 曾嵘[1] 陈跃鑫[1] 刘暴[1] 叶炜[1] 刘昌伟[1] 郑月宏[1] Gu Guangchao;Xiang Wenxuan;Zeng Rong;Chen Yuexin;Liu Bao;Ye Wei;Liu Changwei;Zheng Yuehong(Department of Vascular Surgery,Chinese Academy of Medical Sciences,Peking Union Medical College,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院血管外科,北京100730

出　　处：《血管与腔内血管外科杂志》2024年第12期1409-1412,1422,共5页Journal of Vascular and Endovascular Surgery

基　　金：中央高水平医院临床科研专项项目(2022-PUMCH-A-077、2022-PUMCH-B-100);北京协和医学院“中央高校基本科研业务费”项目(3332024001)。

摘　　要：目的探讨颈部神经鞘瘤的外科治疗经验。方法收集2018年8月至2021年11月于中国医学科学院北京协和医学院北京协和医院进行手术治疗的11例患者的颈部神经鞘瘤患者的临床资料。所有患者均接受手术治疗并完整切除肿瘤,记录肿瘤特征、手术相关指标和术后结局情况。结果11例患者的神经鞘瘤均位于颈动脉间隙,均完成了切除术,包膜内切除9例,神经分支与肿瘤一并切除2例,平均手术时间(139.1±56.4)min,中位出血量20(20,160)ml,平均住院时间(13.6±6.1)d,平均术后住院时间(4.8±1.7)d。7例患者术后出现不同程度神经损伤症状,围手术期无脑梗死或死亡发生。术后随访期间,1例患者神经损伤症状完全消失,其他6例患者神经损伤症状均有所好转,无死亡或肿瘤复发转移发生。结论手术切除是颈部神经鞘瘤主要治疗方法,患者一经诊断,应尽早接受手术,以降低术后并发症发生率。Objective To explore the experience of surgical treatment of cervical schwannoma.Method Clinical data of 11 patients with cervical schwannoma who underwent surgical treatment at Chinese Academy of Medical Sciences,Peking Union Medical College,Peking Union Medical College Hospital from August 2018 to November 2021 were collected.All patients underwent surgical treatment and complete tumor resection.Tumor characteristics,surgery-related indexes and postoperative outcomes were recorded.Result All 11 cases of schwannomas were located in the carotid space,and resection was completed in all of them,including intracapsular resection in 9 cases and resection of nerve branches and tumor in 2 cases.The mean operation time was(139.1±56.4)min,the median intraoperative blood loss was 20(20,160)ml,the mean hospital stay was(13.6±6.1)d,and the average postoperative hospital stay was(4.8±1.7)d.Neurological injury occurred in 7 patients after surgery,with no cerebral infarction or death.Postoperative follow-up showed that the neurological injury symptoms of 1 patient disappeared completely,and the neurological injury symptoms of the other 6 patients were improved,and no death or tumor recurrence and metastasis occurred.Conclusion Surgical resection is the main treatment method for cervical schwannomas,and patients should undergo surgery as early as possible after diagnosis to reduce the incidence of postoperative complications.

关 键 词：颈部神经鞘瘤 手术治疗 术后并发症 

分 类 号：R543[医药卫生—心血管疾病]