颈动脉体瘤分型与手术治疗九例回顾性分析

Retrospective analysis of the classification and treatment of carotid body tumor

目的探讨颈动脉体瘤分型、诊断和手术方法。方法1996年11月-2006年2月收治的颈动脉体瘤9例,其中ShamblinⅠ型4例,Ⅱ型1例,Ⅲ型4例,术前均行DSA。单纯瘤体切除4例,瘤体切除并颈外动脉结扎1例,瘤体切除并颈内静脉、颈内动脉、颈外动脉、迷走神经切除1例,瘤体、颈外动脉切除并颈内、颈总动脉端端吻合2例,瘤体、颈外动脉切除并颈总-颈内动脉自体静脉移植术1例。结果1例手术后1年复发,再次手术后3d死亡;2例舌下神经损伤,其中暂时性舌瘫1例,永久性舌瘫1例。结论DSA在颈动脉体瘤诊断和指导治疗中起重要作用,根据分型选择合理的手术方法,疗效佳且并发症少。

Objective To study the classification, diagnosis and surgical treatment of carotid body tumor. Methods Nine patients from November 1996 to February 2006,including Shamblin type Ⅰ （n = 4 ）, Ⅱ （n = 1 ） and Ⅲ（ n = 4）. All cases were diagnosed by DSA and underwent tumor resection, 4 cases with simple excision, 1 case with tumor resection and external carotid ligatien, 1 case with resection of tumor, jugular vein, internal, external carotid and vagus, 2 cases with resection of tumor, external carotid and anastomosis of common and internal carotid, 1 case with resection of tumor, external and common and internal carotid reconstruction with autogenous vein. Results One case was recurred and died 3 days later after second operation. Two cases had hypoglossal nerve injury, 1 temporary lingual paralysis, the other permanent lingual paralysis. Conclusions DSA plays an important role in the diagnosis and treatment of carotid body tumor. According to Shamblin type, reasonable surgical treatment shows good results with few complications.