颈根部占位性病变的诊断与治疗

Diagnosis and treatment of cervical root space-occupying lesions

目的探讨位于颈根部占位性病变的诊断,选择较佳的手术方案,并减少手术并发症的发生。方法收集2005年1月至2014年1月在山东大学齐鲁医院耳鼻咽喉科住院手术并经病理确诊的147例患者的临床资料并进行分析。结果 147例患者经术后病理结果确诊,其中颈段食管癌56例、胸骨后甲状腺50例、气管肿瘤9例、神经纤维鞘瘤18例、神经纤维瘤9例、淋巴导管囊肿5例。146例患者均行手术完整切除,1例淋巴管囊肿因粘连严重未能全部切除。24例(16.33%)患者发生手术并发症。随访3年,恶性肿瘤患者3年存活率35.62%,良性病变均无瘤生存(除1例未完整切除患者)。结论颈根部占位性病变的首选治疗方案以手术最佳,颈根部解剖结构复杂,手术难度较大,术后并发症较多。

Objective To explore the diagnosis of lesions occupying the root of neck, choose rational surgical plans, and reduce the occurrence of complications. Methods From January 2005 to January 2014, a total of 147 patients with intact data of tumors at the root of the neck, from the Qilu Hospital of Shandong University, were retrospectively analyzed. Results According to pathologic diagnosis, 56 of the 147 cases were esophageal carcinoma, 50 were substernal thyroid, 18 were neurinoma, nine were neurofibro- ma, five were cyst of the lymph-vessel, and nine were tracheal tumors. All tumors were totally resected except for one lymphatic cyst, which was incompletely resected because of conjunction with important tissues.Twenty-four of the 147 cases presented compli- cations （16.33%）. Follow up for three years.The three-year survival rate for patients with malignant tumors was 35.62%. One pa- tient with a lymphatic cyst that was not removed completely did not experience relapse. Condusion The best therapeutic regimen for the treatment of lesions occupying the root of neck was operation, however the complicated anatomical structure of this region makes it difficult to perform operations without resulting complications.