25例颈动脉体化学感受器瘤的手术治疗

Surgical approaches to carotid artery chemodectoma of 25 patients

目的 总结 2 5例颈动脉体瘤临床资料 ,探讨并评估提高手术成功率和减少严重并发症的方法。方法 研究 1983 .1.～ 2 0 0 3 .1.收治的 2 5例颈动脉体瘤的的诊断方法、治疗措施和预后效果。结果 2 5例中 2 6次手术治疗 ,3例行肿瘤摘除术 ,9例将肿瘤从颈动脉窦区完整剥离 ;7例连同颈外动脉切除 ,对颈动脉分叉或颈内动脉起始部的破口施行修补 ;7例术中同肿瘤一起切除颈总动脉、颈内动脉 ,其中 1例进行颈内外动脉吻合。 1例术前施行了颈内动脉和颈总动脉球囊栓塞 ,除 1例术后死亡外均未发生严重颅脑并发症。结论 综合性检测有利于术前的确诊 ,选择性颈动脉造影对术前确诊意义重大 ;颈内动脉、颈总动脉的正确处理是减少手术并发症的关键 ,应尽力争取保留颈内动脉 ;颈动脉压迫训练效果是肯定的和有效的 。

Objective To investigate the dia gnostic and therapeutic approaches to c arotid artery chemodectoma. Method Retrospective study of diagn osis and treatmen t of 25 patients with carotid artery chemodectoma between 1983-2002.Res ult 25 patients(26 cases) were treated by a curative resection of the neoplasm. 3 tumor s were enucleated, 9 were resected with ligation of external carotid artery, 7 t umors and external carotid artery were resected with repair of crevasse of the c ommon or beginning of internal carotid artery, and 7 had internal and common car otid artery resected, in which 1 case had internal and external artery anastomos ed near skull base. No early and late deaths but one occurred and no recurrences were detected at follow-up.Conclusion Comprehensive examinatio n, especially ca rotid artery angiography is helpful for diagnosis accuracy, ultra sound is usefu l during mass survey. Correct treatment of internal and common carotid artery is of great importance and artery repair is recommended. Metas' training effect and examina tion of cerebrum lateral branch circulation by carotid arteriography is affirmat ive and objective, preoperative selective embolization and local anesthesia are favorable to prevent undue operative risks and complications. anesthesia