92例颈动脉体瘤患者的诊断与外科治疗经验分析

Diagnosis and surgical treatment of 92 cases of carotid body tumor

目的总结笔者科室治疗颈动脉体瘤(CBT)患者的经验,为CBT的诊断与外科治疗提供参考依据。方法选择2003年10月至2017年10月间在本院接受手术的92例CBT患者为研究对象,对其手术过程和经验进行总结,术后进行随访,观察患者术后并发症及预后。结果92例CBT患者(102个病灶)共有27个病变被分类为ShamblinⅠ级,37个为Ⅱ级,28个为Ⅲ级。手术切除CBT 63例,切除CBT和颈外动脉28例,切除CBT和颈内动脉1例,所有患者均未观察到偏瘫。在2例ShamblinⅢ级患者中观察到声音嘶哑和屈曲,并在激素治疗和神经营养策略实施后1个月消除。随访期间未观察到复发或死亡。结论建议在诊断后手术切除CBT。影像学特征和脑侧支循环的评估对治疗很重要。

Objective To illustrate the diagnosis and treatment of carotid body tumor(CBT)based on our experience of previous patients.Methods A total of 92 patients with CBT who received surgery between October 2003 and October 2017 were included to summarize the operation process and experience and obsever the postoperative follow-up,postoperative complications and prognosis.Results 92 patients(102 lesions)in total,27 lesions were categorized into Shamblin gradeⅠ,37 were gradeⅡ,and 28 were gradeⅢ.Surgical resection of CBT was performed for 63 lesions,resection of CBT and the external carotid artery was performed for 28 lesions,and resection of CBT and the internal carotid artery was performed for 1 lesion.No hemiplegia was observed.Hoarseness and bucking were observed in 2 patients of Shamblin gradeⅢ,and were eliminated 1 month subsequent to the administration of hormone therapy and a nerve-nurturing strategy.No relapse or mortality was observed during the follow-up.Conclusions Surgical resection of CBT is recommended following diagnosis.The evaluation of imaging features and cerebral collateral circulation is important for treatment.