华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

选择性血管栓塞术辅助颈动脉体瘤切除术

胡敏1 张立海2 杨舸1 陈丽洁1 湛雄3   

  1. 1.中国人民解放军总医院口腔科; 2.骨科, 北京100853; 3.中国人民解放军空军总医院口腔科, 北京100142
  • 收稿日期:2010-08-25 修回日期:2010-08-25 出版日期:2010-08-20 发布日期:2010-08-20
  • 通讯作者: 胡敏,Tel:010-66938117
  • 作者简介:胡敏(1956—),男,北京人,教授,博士

Selective embolization for surgical treatment of carotid body tumor

HU Min1, ZHANG Li-hai2, YANG Ge1, CHEN Li-jie1, ZHAN Xiong3   

  1. 1. Dept. of Stomatology, Chinese PLA General Hospital, Beijing 100853, China; 2. Dept. of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China; 3. Dept. of Stomatology, Air Force General Hospital, PLA, Beijing 100142, China
  • Received:2010-08-25 Revised:2010-08-25 Online:2010-08-20 Published:2010-08-20
  • Contact: HU Min,Tel:010-66938117

摘要:

目的观察颈动脉造影及选择性血管栓塞术对颈动脉体瘤切除术的影响。方法选择7例颈动脉体瘤患者为研究对象,其中4例于手术前行颈动脉造影及选择性血管栓塞术,其余3例不行血管栓塞术。7例患者均行手术治疗,均采取剥离肿瘤与颈动脉的术式,比较术前行选择性血管栓塞与否的治疗效果。结果7例患者的颈动脉体瘤均为Shamblin Ⅲ型,CT以及三维重建影像能清楚显示肿瘤及其与周围动脉的关系。所有病例均完整切除肿瘤而未结扎颈内、颈外动脉,术后均无严重并发症发生。4例术前行选择性血管栓塞术的患者术中出血量平均为160 mL,手术时间平均为2.5 h;3例未行血管栓塞术患者的术中出血量平均为600 mL,手术时间平均为4 h。术后随访1.5~3年,7例患者均无复发。结论颈动脉体瘤术前行颈动脉造影和选择性血管栓塞术可以有效减少术中出血,有助于降低手术的风险。

关键词: 颈动脉体瘤, 数字减影血管造影, 栓塞

Abstract:

Objective To investigate the value of carotid arteriography and selective embolization in surgical treatment of carotid body tumor. Methods Seven patients with carotid body tumor were operated, and four patients were performed with carotid arteriography and selective embolization before operation. All patients were treated by stripping the carotid body tumor from the carotid artery. Treatment effectiveness of the patients with and without selective embolization were compared. Results Seven cases were classified as Shamblin Ⅲ type. The CT scan and digital subtraction angiography(DSA) showed the tumor lesion in the carotid bifurcation, and the tumor and its relation with the surrounding arteries were expressed by CT and three dimensional CT images. All cases of carotid body tumor were resected without any carotid artery ligation. No serious complications occurred after operation. There was average 160 mL blood loss in operation of four patients that had angiograms and were preoperatively embolized, and average 2.5 h were expended. There was average 600 mL blood loss in operation of three patients without preoperatively embolized, and average 4 h were expended. Preoperatively high-selected embolization of the tumor-feeding artery could effectively reduce the intraoperative bleeding. With 1.5-3 years follow-up, none of the carotid body tumor recurred in all the seven cases. Conclusion Carotid arteriography and embolization therapy may decrease blood loss and higher risk for operation in the patients with carotid body tumor.

Key words: carotid body tumor, digital subtraction angiography, embolization