颅外颈动脉瘤外科治疗的若干问题(附27例报告)

SURGICAL MANAGEMENT OF EXTRACRANIAL CAROTID ARTERY ANEURYSM: A REPORT OF 27 CASES

颅外颈动脉瘤相当罕见,若不手术治疗,其预后极差。自1953～1990年,共收治27例,男性15例,女性12例,年龄5～68岁,平均年龄34.5岁。25例接受手术治疗,其中13例次行动脉瘤切除自体大隐静脉移植,3例动脉瘤切除,动脉端端吻合,1例颈总动脉结扎,8例行动脉瘤切除,近远端动脉结扎,1例行外包裹术。术后死亡一例。在长期随访中,2例死于心肌梗塞,1例死于脑动脉栓塞。5年存活率86.14％。

Aneurysm of the extracranial carotid artery has a poor prognosis if left untreated. From 1953 to 1990, 25 patients (26 aneurysms) were operated upon. resection of the aneurysm with autogenous interposition vein graft was performed in 13, Resection with end-to-end anastomosis in 3, resection with proximal and distal ligation in 8, ligation of the common carotid artery and warpping of the aneurysm in 1 each. One patient died in hospital because of carotid artery thrombosis. Three patients had permanent recurrent laryngeal nerve paralysis. On long-term follow-up, 2 died of myocardial infarction and 1 of corotid thrombosis. The overall 5-year survival rate was 86.4% The results show that accessible aneyrysm of the extracranial carotid artery can be excise with an acceptable morbidity and mortality.