颈动脉体瘤的诊断和治疗

Diagnosis and Therapy of Carotid Body Tumors

目的：探讨颈动脉体瘤的诊治经验，提高诊断准确率和手术成功率，降低并发症发生率。方法：回顾分析1996—2005年收治的30例颈动脉体瘤患者的临床资料。结果：30例患者均行DSA检查，均诊断为颈动脉体瘤；B超检查14例，12例诊断为颈动脉体瘤；CT检查20例，16例诊断为颈动脉体瘤；MRI／MRA检查16例，14例诊断为颈动脉体瘤。22例患者行TBO检查，8例为阳性。30例患者均行手术治疗，29例患者预后良好，1例发生永久性偏瘫，随诊期间无肿瘤复发。结论：DSA检查是诊断颈动脉体瘤的最佳方法，而MRI／MRA和BUS检查在颈动脉体瘤的诊断中具有重要价值。手术切除是治疗颈动脉体瘤的首选治疗措施。DSA和TBO同时检查，能为制定手术方案提供重要参考。应做好充分的术前准备，术前常规行Matas训练。术中精细的解剖可以降低术后并发症的发生。

Objective： To summarize the experience in diagnosis and therapy of carotid body tumor, promote the rate of diagnosis and successful rate of operation and minimize intra and postoperative complications, Methods： A retrospective study was based on 30 patients with carotid body tumors diagnosed and treated between 1996 and 2005, Results： 30 patients underwent digital subtraction angiography（ DSA）, all of which were considered as carotid body tumors, B ultrasonography was performed in 14 cases, among which 12 cases were correctly diagnosed, Twenty cases underwent computed tomography, among which 16 cases were considered as carotid body tumors, Magnetic resonance imaging and magnetic resonance angiography were performed in 16 cases, among which 14 cases were considered as carotid body tumors, Twenty - two cases underwent temporary balloon occlusion（ TBO）, among which 8 cases were positive. All 30 cases received surgical operation with different kinds of procedures, all of which had no mortality and recurrence during the follow - up period, but longlasting hemiplegia happened in 1 case. Conclusion： DSA examination is the best method to diagnose carotid body tumors. MRI/MRA and BUS are valuable to diagnose carotid body tumors. Surgery is the first choice to carotid body tumors, DSA and TBO examination can help to draw out and decide reasonable treatment method. Enough preoperative preparation is necessary. Matas training method shoud be adopted, Intraoperative meticulous dissection may reduce the in- cidence of postoperative complication.