颈动脉体瘤的临床诊治

Clinical diagnosis and treatment of carotid body tumor

目的探讨颈动脉体瘤(CBT)的诊断、治疗方式及术后并发症。方法回顾性分析2016年4月至2016年9月我科收治的5例颈部肿物患者的临床资料。根据Shamblin分型标准:Ⅰ型1例,Ⅱ型2例,Ⅲ型2例。1例ShamblinⅠ型及2例ShamblinⅡ型患者行单纯肿物剥离术,1例ShamblinⅢ型患者行肿物切除+血管重建术,1例ShamblinⅢ型患者行血管内介入栓塞术。结果 1例ShamblinⅠ型患者术后病理确诊为神经鞘瘤,余患者病理均为副神经节瘤。1例ShamblinⅢ型患者行血管内介入栓塞术后出现偏瘫,余4例手术患者均完整切除肿瘤,无死亡、偏瘫及神经功能障碍。结论影像学检查是诊断CBT的最佳方法,手术切除是其首选治疗方式,通过完整、有效的术前评估和选择合理的治疗方案可以有效预防和减少术后并发症的发生。

Objective To study the clinical diagnosis and treatment of carotid body tumor（CBT）.Methods The clinical data of 5 patients with cervical tumor in our department from Apr. 2016 to Sep.2016 were analyzed retrospectively. Based on Shamblin classification, there were 1 Shamblin Ⅰ case, 2 Shamblin Ⅱ cases and 2 Shamblin Ⅲ cases. And 1 Shamblin I and 2 Shamblin Ⅱ patients were underwent only tumor resecting, 1 Shamblin Ⅲ patient was performed tumor resecting and vascular reconstruction, 1 Shamblin Ⅲ patient accepted endovascular interventional embolization. Results Postoperative pathological diagnosis of 1 Shamblin Ⅲ case was schwannoma, and CBT diagnosis was confirmed for the rest by pathological method. Tumors were totally removed in 4 cases, and none of the patients died or presented cranial nerve palsy, except 1 case accept tumor embolization developed transient hemiplegia. Conclusion Imaging examination is the best method for diagnosing CBT. Surgery is the first choice of the treatment of CBT. Rational choice of therapeutic scheme can prevent and reduce the occurrence of complications effectively by making a complete and effective preoperative assessment.