颈动脉体瘤与颈总动脉分叉处神经源性肿瘤对照

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论著

文章编号：1005-2208（2012）12-1023-04

颈动脉体瘤与颈总动脉分叉处

神经源性肿瘤对照研究

李光鑫，辛世杰，张

健，杨

栋，丁

奎，王

雷，李

璇，段志泉

【摘要】目的探讨颈动脉体瘤与颈总动脉分叉处神经源性肿瘤的鉴别要点和手术治疗经验。方法回顾性分析2004年11月至2011年6月中国医科大学附属第一医院手术治疗的颈动脉体瘤16例和颈总动脉分叉处神经源性肿瘤14例的临床资料，对比分析两组的临床表现、影像学资料、手术过程及随访等。结果两组的年龄、性别、既往状况、临床表现差异均无统计学意义，虽然两组的肿瘤大小差异也无统计学意义，但颈动脉体瘤组的手术时间要显著长于神经源性肿瘤组［（119±46）vs.（65±13）min，P<0.05］，前者的术中失血量也显著高于后者［（230±127）vs.（89±38）mL，P<0.05］。颈动脉体瘤组手术完整切除肿瘤15例（15/16，93.8%），6例行自体大隐静脉移植、颈内动脉重建术；术后出现轻度舌下神经受损症状1例，出现Horner综合征1例。神经源性肿瘤组14例全部完整切除，均未阻断颈动脉血流；术后出现声音嘶哑1例，Horner综合征3例。两组间并发症发生率的差异无统计学意义（P>0.05），住院时间两组差异亦无统计学意义［（17±7）dvs.（14±5）d，P>0.05］。结论分的术前评估及相关准备是手术成功的关键。【关键词】颈动脉体瘤；神经源性肿瘤；外科手术中图分类号：R6文献标志码：A

Carotidbodytumorsandneurogenictumorsatbifurcationofcarotidartery：acontrolstudyMedicalUniversity,Shenyang110001,China

Correspondingauthor:XINShi-jie,E-mail:sjxin@Abstract

tumorsandneurogenictumorsatbifurcationofcarotidartery.Methods

Objective

Toexploretheexperiencesfordifferentialdiagnosisandsurgicaltreatmentofcarotidbody

Theclinicaldataof16casesofcarotidbody

ThereisnoLIGuang-xin,

颈动脉体

瘤与颈总动脉分叉处神经源性肿瘤的临床表现十分相似，术前确诊有一定困难，手术切除是有效的治疗方法，充

XINShi-jie,ZHANGJian,etal.DepartmentofVascularandThyroidSurgery,theFirstAffiliatedHospitalofChina

tumorsand14casesofneurogenictumorsatbifurcationofcarotidarteryperformedoperationbetweenNovember2004manifestations,imagingfeatures,surgicalproceduresandfollowupofthecaseswerecompared.Results

andJune2011intheFirstAffiliatedHospitalofChinaMedicalUniversitywereanalyzedretrospectively.Theclinicalstatisticaldifferenceofage,sex,physicalcondition,clinicalmanifestationandsizeoftumorsbetweentwogroups.Theoperatingtime［（119±46）min］andbleedingvolume［（230±127）mL］oftheformergroupwereobviouslylargerthanthose［（65±13）min，（89±38）mL］ofthelatergroup（P<0.05）.Fifteencasesoftheformergrouphadtotaltumorresection.Sixofthemhadreconstructionofinternalcarotidarteryusinggreatsaphenousveingraft.Allcasesofthelatergrouphadtotaltumorresectionwithoutoccludingcarotidartery.Onecaseoftheformergrouphadminimaldamageofhadhoarseness.ThreecasesofthelatergrouphadHornersyndromeaftertheoperations.Therewasnodifferenceinthanthatofthelatergroup［（14±5）d］（P>0.05）.Conclusion

hypoglossalnerve.OnecaseoftheformergrouphadHornersyndromeaftertheoperations.Onecaseofthelatergroupincidenceofcomplicationbetweentwogroups(P>0.05).Thehospitalstayoftheformergroup［（17±7）d］waslongerneurogenictumorsatbifurcationofcarotidarteryaresimilar.It’sdifficulttodiagnoseexactlybeforeoperation.Surgical

factorsforsuccessfultreatment.Keywordssurgicaloperation

Theclinicalmanifestationsofcarotidbodytumorsand

operationisanavailabletreatment.Aclearunderstandingofthediseaseandsufficientpreparebeforeoperationarekey

作者单位：中国医科大学附属第一医院普通外科教研室血管甲状腺外科，辽宁沈阳110001

通讯作者：辛世杰，E-mail：sjxin@

carotidbodytumor；neurogenictumor；

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