【摘要】 目的探讨介入联合颈内动脉转流在Ⅲ型颈动脉体瘤切除术中的应用及效果。方法回顾性分析笔者所在医院自2002年1月至2012年7月期间收治的21例(22侧)Ⅲ型颈动脉体瘤患者的临床资料。21例患者术前经充分评估后,于术前2~3 d均用微导管对供瘤血管行超选择栓塞治疗,然后在颈内动脉转流下行颈动脉体瘤切除术。结果 21例(22侧)手术均顺利完成,术后经病理学检查证实均为颈动脉体瘤。其中行颈动脉瘤切除术16例(17侧),瘤体切除+颈内动脉重建5例(其中自体大隐静脉3例,人工血管2例)。术后当天则出现神经并发症5例(舌歪3例,面部麻木2例),术后3个月内均恢复正常;无脑梗塞、偏瘫和死亡病例。21例均获随访,随访时间2个月~9年,平均57个月,无复发病例。结论颈动脉体瘤首选的治疗方式是外科切除,介入联合颈内动脉转流下切除Ⅲ型颈动脉体瘤瘤体是安全有效的。更多还原

【Abstract】 Objective To investigate the experience of selective embolization combined with intraoperative internal carotid artery shunt for surgical treatment of carotid body tumor (CBT). Methods The data of 21 patients (22 sides)with CBT who underwent surgical resection from January 2002 to July 2012 in our hospital were retrospectively reviewed. The all patients’ conditions were fully assessmented and all patients were performed the carotid arteriography and superselective embolization treatment for the blood supply of tumor by with microcatheter on 2-3 days before operation, and then intraoperative internal carotid artery shunt and resection of carotid body tumors were performed. Results Surgical procedures were successfully performeded in all 21 patients (22 sides). Among them,16 patients(17 sides)were taken carotid body tumor resected,5 patients were taken carotid body tumor resected and internal carotid artery reconstruction(autogenous long saphenous vein were used in 3 patients,vascular prosthesis were used in 2 patients). The postoperative complications were found in 5 patients after anesthesia recovery,which included crooked tongue in 3 cases and facial numbness in 2 cases,and they were cured in 3 months. There were no cerebral infarction,hemiplegia,and death cases. All 21 patients were followed-up for a period from 2 months to 9 years (average 57 months),there was no tumor recurred. Conclusions Surgical resection is the first choice for treatment of carotid body tumor. The application of selective embolization and intraoperative internal carotid artery shunt for surgical treatment of carotid body tumor in complicated Shamblin Ⅲ stage is safe and effective.更多还原