颅外颈动脉瘤的诊断及手术治疗

Diagnosis and surgical treatment of the extracranial carotid aneurysm

目的：探讨颅外颈动脉瘤的诊治。方法：分析了两例复杂性颅外颈动脉瘤的发病、症征、诊断，手术经过及结果。结果：两例均得到成功的诊治。随访4－6年，效果满意。结论：经验是（1）选择性颈动脉造影术对诊断及手术选择有很大的帮助，术前忌作诊断性穿刺；（2）一旦确诊应尽快手术。宜作胸颈切口，结扎颈动脉、切除动脉瘤、血管移植；（3）术前尽可能训练后阻断颈动脉，术后采用冯友贤10原则保护脑供血；（4）本组一例术后持续高血压，极为罕见，值得探讨。

To probe the diagnosis and treatment of extracranial carotid aneurysm. method: The pathogenesis, signs and symptoms, processes of diagnosis and surgical treatment and the results in two cases of extracranial carotid aneurysm were analysed. results:This two cases all acquired successful diagnosis and treatment. Their results were satisfid in the 4 and 6 years following up. conclusion: (1)Selective arteriography is very helpful for the diagnosis and operation choosing in this disease and diagnostic puncture must be avoided before operation; (2) Once this disease is definitely diagnosed, than the operation should be done as early as possible. A cervico-thoracic incision is available, the aneurysm should be incised and blood vessel should be transplantal; (3)Cerebral blood supply should be trained before ligation of cervical arteries. The Fang You-xian's ten principles should be applied after operation to protect the cerebral blood supply; (4)In this group, ore case sustained continued hypertension postoperatively, it is seen very rare and is worth for further study.