颈动脉体瘤

Carotid body tumor

目的探讨颈动脉体瘤的诊断和手术治疗。方法1993年8月至2006年10月收住43例患者,其中38例接受手术,回顾分析患者的临床表现、影像学资料、手术及随访结果。结果38例（39个）颈动脉体瘤手术中,11个肿瘤切除,动脉完好;16个肿瘤切除同时结扎或切断（除）了颈外动脉;5个肿瘤切除后,需缝合或修补动脉破损;7个肿瘤术中需取大隐静脉与颈总、颈内动脉端-端吻合,重建颈动脉血流。术后22例（58%）恢复顺利,13例（34%）出现不同程度颅神经或交感神经损害征象,3例（8%）出现脑缺血。无死亡。结论颈动脉体瘤少见,虽临床表现较具特征,但可能被误诊。一旦确诊,应及早手术。术中特别注意远端颈内动脉显露,严格沿动脉外膜-肿瘤“被膜”界面锐性分离,尽量防止损伤颅神经。显微外科技术有助于降低手术并发症。

Objective To explore the diagnosis and surgical treatment of carotid body tumor. Methods Retrospectively analyse the clinical data of forty-three patients with carotid body tumor admitted in our hospital since August 1993 to October 2006, of which thirty-eight were operated on. Results In all thirty-nine tumors, 11 tumors were totally removed with preservation of the carotid artery, 16 removed with ligating or resecting the external carotid artery, 5 removed with suturing or repairing the ruptured artery, 7 removed with reconstruction of carotid artery using ＂saphenous vein graft. After operation, 22 patients recovered uneventfully, while 13 developed cranial nerve injury, 3 experienced brain ischemia. No death occurred. Conclusion The carotid body tumor is rare. Although the clinical presentations are rather characteristic, misdiagnosis is not very rare. Surgical treatment is recommended. Exposure of the distal internal carotid artery, dissecting in the adventitial- capsular plane, and preventing the cranial and sympathetic nerves from injury are emphasized during operation. Microsurgical technigues are valuable to lowering the surgical complications.