颈动脉分叉处肿块的诊断与治疗

Diagnosis and treatment of tumors at bifurcation of carotid artery

目的探讨颈动脉分叉处肿块的诊断和手术治疗方法。方法回顾性分析2004年2月—2007年11月收治的11例颈动脉分叉处肿块患者的临床资料。结果 11例中7例为颈动脉体瘤,其中6例手术,1例拒绝手术;4例为神经鞘瘤,均手术治疗。10例手术均完整切除肿瘤,2例行自体大隐静脉移植颈动脉重建术。6例手术者获0.5～3年随访,效果良好。结论颈动脉分叉处肿块的性质临床诊断较难,尤其颈动脉体瘤与神经鞘瘤鉴别困难。术前应明确肿块与颈部大血管的关系及脑供血情况,术中应充分保证颈内动脉血供,保护神经,并尽量减少局部组织粘连及瘢痕形成机会。

Objective To explore the methods for diagnosis and treatment of tumors at bifurcation of carotid artery. Methods We retrospectively analyzed the clinical data of 11 cases of tumors at bifurcation of carotid artery who admitted in our hospital from February 2004 to November 2007. Results Seven of the 11 cases were carotid body tumors of which six underwent operation and one case refused surgical treatment. The other 4 cases were neurinoma and underwent operation. All of the 10 operated patients had total tumor resection; 2 of them had reconstruction of carotid artery using great saphenous vein graft. Six operated patients were followed up for 0.5-6 years, the results were good.Conclusions Exact diagnosis of tumors at bifurcation of carotid artery, especially the differential diagnosis of carotid body tumor and neurinoma, is diffecult. A clear understanding of the relationship between the tumor and the blood vessels and the condition of Willis circle is necessary before operation, and equally important is ensuring the blood supply from internal carotid artery and protecting nerves during the procedure of the operation.