颈动脉体瘤外科治疗并发症的分析

Analysis of complications on surgical treatment of carotid body tumors

目的 :总结 46例颈动脉体瘤手术治疗结果以及并发症防治的经验。方法 :对采用肿瘤剥除术、同时切除颈外动脉术、与颈动脉分叉一并切除后血管重建术以及颈总动脉结扎术等方法治疗的颈动脉体瘤手术效果和并发症进行回顾性分析。结果 :手术切除率 91 3%。偏瘫 2例 ,舌下神经损伤 4例 ,舌咽神经损伤 2例 ,迷走神经损伤 1例 ,副神经损伤 1例 ,其中 1例同时有舌咽、迷走、舌下神经损伤。长期随访复发 2例 ,再次手术切除。所有病例无手术死亡。结论 :术前选择性血管造影、血管超声多普勒等检查以明确诊断 ,合理的Matas训练以及选择适当的术式 ,对于颈动脉体瘤外科治疗和减少并发症是必要的。

Objective: Effects of surgical treatment and complications in our division were summerized in patients with paragangliomas.Methods: Retrospective study of 53 paragangliomas was carried out in 46 cases which were surgically treated with different kind of procedures.Results: No operative mortality was observed. There were 2 hemeplesia, 4 hypoglossal n. impairment, 2 glossopharyngeal n. impairment, and 1 accessory n. impairment. One patient presented simultaneously with a postoperative cranial nerves deficits (glossopharyngeal, vagus and hypoglossal nerve).Two patients developed local recurrence during the long term follow-up.Conclusion: Complete surgical excision is possible in each patient if diagnosis is correctly made through selective preoperative angiograph, vessel ultrasound and other inspections. Reasonable surgical procedure and Matas training are necessary to the successful surgical treatment and decreasing complication incidence rate of carotid chemodectomas.