10例颈动脉体瘤的诊断和治疗体会

Diagnosis and Surgical Treatment of 10 Carotid Body Tumors

目的:探讨颈动脉体瘤的临床诊断和治疗经验。方法:对10例颈动脉体瘤患者的临床资料进行回顾。结果:10例颈动脉体瘤患者,男6例,女4例,均接受手术治疗。术前分别进行超声波、数字减影血管造影(digitalsubtraction angiography,DSA)、计算机X线断层扫描(computed tomography,CT)、磁共振成像(magnetic reso-nance imaging,MRI)及CT血管成像(computed tomography angiography,CTA)检查。术前行Matas试验2例,7例颈动脉体瘤被单纯剥离切除,2例行包括颈外动脉在内的瘤体切除术,1例行人工血管重建颈内动脉。术后1例出现暂时性舌下神经受累,1例交感神经受累,2例迷走神经受累,3个月后症状完全恢复。无偏瘫和死亡病例。结论:颈动脉体瘤患者术前完善检查和准备非常重要,CTA在诊断中具有良好作用。较小的肿瘤可以完整剥除;与颈外动脉包绕紧密的一并切除颈外动脉;与颈内动脉包绕紧密难以剥离的可以行人工血管重建。

Objective： To investigate the diagnosis and therapeutic approaches of carotid body tumors （CBT）. Methods： In retrospect of clinical data of diagnosis and operation of 10 cases CBT patients hospitalized from 1990 to 2011. Results： 6 males and 4 female patients were analyzed. B ultrasound, DSA, MRI, CTA were used as the mo- dalities of diagnosis for 10 CBT cases. All patients were submitted to surgical resection of the tumor. Preoperative Matas test was carried out in 2 patients. 7 patients underwent simple CBT enucleation. 2 CBT patients underwent external carotid artery resection. 1 CBT underwent en bloc resection with carotid artery reconstruction. Postoperatively, paralysis of hypoglossal and sympathetic occurred temporarily in one patients, paralysis of pneumogastric occurred in temporarily two patient, no hemiplegia and death occured. Conclusion： It is important to examine and pre- pare completely pre-operation in CBT surgery. CTA have good effect in the diagnosis of CBT. Enucleation can be done for small CBT. External carotid artery can be removed with CBT if involved tightly. Reconstruction of the internal carotid artery can be done if the internal carotid artery is involved seriously.