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1、104ChineseJournalofModernOperativeSurgery,Apr.2009,Vol.13,No.2·临床论著·[文章编号]1009-2188(2009)02-0104-04颈动脉体瘤的诊断和治疗韦正波,许坚,莫立根,杨剑波(广西医科大学附属肿瘤医院头颈外科,南宁530021)[摘要]目的总结颈动脉体瘤的诊治经验,探讨颈动脉体瘤的诊断、术前准备、手术方法和并发症的防治。方法10例颈动脉体瘤患者,5例首诊时误诊为其他疾病。3例术前行数字减影血管造影检查,9例行B超检查,1例行ECT检查,5例行CT检查,3例行MRI检查,2例行脑血流图检查,仅3例手术
2、前行颈动脉压迫试验。7例采用单纯瘤体切除,1例行瘤体与颈外动脉切除,1例行瘤体与部分颈总动脉、分叉及颈内、外动脉一同切除,未做颈动脉重建,1例瘤体切除同时行部分颈总动脉、分叉及颈内、外动脉切除,并行自体大隐静脉移植术。结果本组术后无死亡、偏瘫和失明病例,1例出现患侧口角歪斜,2例出现霍纳综合征,2例出现声嘶、呛咳,2例出现吞咽困难,3例出现舌歪。9例获随访,时间1～12年,无复发病例。结论临床医师应提高对颈动脉体瘤的认识,注意选择合适的检查方法以免误诊;充分的术前准备、良好的肿瘤暴露和手术技巧、精心的术后护理是治愈该病、预防并发症的关键。[关键词]颈动脉体瘤;大隐静脉移植
3、[中图分类号]R732.21[文献标识码]BDiagnosisandTreatmentofCarotidBodyTumorWEIZheng2bo,XUJian,MOLi2gen,YANGJian2bo(DepartmentofCephalocevicalSurgery,AffiliatedTumorHospitalofGuangxiMedicalUniversity,Nanning530021,Guangxi,China)Abstract:ObjectiveToexplorethediagnosis,preoperativepreparations,operationme
4、thodsandpre2ventionofcomplicationforthecarotidbodytumor(CBT).Methods10casesofCBTswereenrolled,inwhom5gotdefinitediagnosisbeforeoperation.Thepreoperativeexaminationsincludeddigitalsubtractionradio2graphyin3,9ultrasonography,1emissioncomputedtomography,5CT,3MRI,and2rheoencephalogram.Only3pa
5、tientsreceivedMatastest.7patientsunderwentresectionofthetumoronly,1resectionoftumorwithexternalcarotidartery,1resectionoftumorwithcommoncarotidartery,carotidarterybifurcation,externalandinternalcarotidartery,1experiencedreconstructionofcarotidarterybysaphenousveingraftingafterresectionoft
6、umorandcarotidartery(includingcommoncarotidartery,carotidarterybifurcation,externalandinternalca2rotidartery).ResultsNopatientdied,norparalysisorblindaftersurgeryexcept1ofdistortionofcommis2sure,of2Horner'ssyndrome,2ofcerchnusandbucking,2ofdysphagia,and3ofcrookedtongue.9patientswerefollow
7、edupfor1to12yearswithouttumorrecurrence.ConclusionsItisthekeytochoosethesuitableexaminationsforpreventingmisdiagnosisofcarotidbodytumor.Itiscriticalofsufficientpreoperativeprepara2tion,satisfactorydiscloseoftumor,goodoperationtechnique,carefulpostoperativenursingtoi
