颈动脉三角区肿瘤术前准备的研究

The study of pre - operative examination of the tumors in carotid arterial region

目的:对81例颈动脉三角区肿瘤术前准备情况进行统计、归纳和分析,就其临床意义进行探讨.方法:对资料就性别、年龄、病理、手术情况进行统计,归纳出术前准备各种方法.结果:B超在颈动脉三角区肿瘤术前应用率为100%(81/81),CDFI为88%(71/81),瘤腔造影为39%(28/81),选择性颈动脉造影为25%(18/81),CT为15%;在选择性颈动脉造影组中,颈动脉体瘤、神经鞘膜瘤与血管瘤之间差异显著(P<0.01);瘤腔造影组中,腮裂囊肿占68%,血管瘤占32%;CT组中,恶性肿瘤占67%,良性肿瘤占33%;Matas试验组中,应用于颈动脉体瘤为80%.结论:(1)B超因其价廉、检查方便而成为常规特检手段;(2)CDFI临床应用效果明显优于B超,原因是B超不能显示血流情况.但其较B超应用率低的原因是价格较贵;(3)在B超、CDFI应用基础上,选择性颈动脉造影、瘤腔造影、CT成为一种特异性检查手段:(4)Matas试验以颈动脉体瘤为 主,时间以30天为宜,指压更为可靠.

Objective: It was collected and analyzed data of 81 cases of the tumors in carotid arterial region and then discussed the clini-cal significance of various examinations and diagnostic methods used on patients of different types of tumors. Methods: The 81 patients were classified by types of tumors and pre - operative examinations methods used before operation. The result of operations and the appropriateness of pre - operative examination and diagnostic methods were discussed. Results: Ultrasonic examination was the first commonly used pre - oper-ative examination method(100% ) . Among other examination and diagnostic methods, CDFI was the second most commonly used method across various tumors (71/81, 88%). Selective carotid arteriography was used by most patients with branchial cyst and angioma (28/81, 39 % ). CT was used by more than half of the patients of metastatic tumor and malignant lymphoms as the additional diagnostic method for some patients of carotid body tumor and neurinoma (12/81, 15 % ) . Finally, Matas was used as the additional examination method by pa-tients of carotid body tumor and by some patients of neurinoma and angioma. The duration of Matas test was 30 days for 8 patients(8/9, 89%). Conclusions:Ultrasonic examination was used by all patients because it was convenient and inexpensive. CDFI was used by 88% of patients because this method could provide more important data for doctors to choose better treatment. But CDFI was more expensive than ul-trasonic examination. After using ultrasonic arteriography, and CT for some more complicated cases. Finally, Matas test was used by 4 out of 5 patients with carotid body tumor, and 5 other patients with neurinoma or angioma. The preferred duration is 30 days and more effective method is by finger pressure.