华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

26例颈动脉体瘤的临床分析

袁荣涛1,郑家伟2,叶为民2,竺涵光2,张志愿2   

  1. 1.青岛大学医学院附属医院 口腔颌面外科,山东 青岛266003; 2.上海交通大学附属第九人民医院 口腔颌面外科,上海200011
  • 收稿日期:2005-12-25 修回日期:2005-12-25 出版日期:2005-12-20 发布日期:2005-12-20
  • 通讯作者: 张志愿,Tel: 021-63138341-5385
  • 作者简介:荣涛(1970-),男,山东人,主治医师,博士

Carotid Body Tumor: A Retrospective Study of 26 Consecutive Cases

YUANRong-tao1,ZHENGJia-wei2,YE Wei-min2,ZHUHan-guang2,ZHANG Zhi-yuan2   

  1. 1.Dept.ofOral and Maxillofacial Surgery,The AffiliatedHospital Medical College, Qingdao University,Qingdao266003,China; 2.Dept.ofOral andMaxillofacial Surgery,The AffiliatedNinth People′sHospi- tal,School ofStomatology,Shanghai Jiaotong University,Shanghai200011,China
  • Received:2005-12-25 Revised:2005-12-25 Online:2005-12-20 Published:2005-12-20

摘要: 目的 研究颈动脉体瘤的临床表现、诊断以及手术方法,为临床诊治提供参考。方法 回顾上海交通大 学附属第九人民医院1993~2004年收治的26例病理证实为颈动脉体瘤的手术病例,分析其年龄、性别、临床特点、 影像学表现、治疗和预后情况。结果 26例颈动脉体瘤患者,男女之比为1∶2·25,中位年龄为36岁;其中2例为双 侧颈动脉体瘤,1例为恶性颈动脉体瘤。21例患者术前行磁共振血管造影、数字减影血管造影及暂时性球囊阻断 试验(TBO)评价,其中6例为TBO阳性。11例行多普勒检查,9例行颈部CT,5例行磁共振成像。26例患者均采用 手术治疗,除切除肿瘤外,其中5例还行颈动脉人工血管重建,4例行颈动脉修补术,1例行颈总、颈内动脉吻合术,1 例切除部分迷走神经。所有病例均预后良好,无脑神经并发症发生,无死亡,随诊未见肿瘤复发。结论 血管造影 和多普勒检查在颈动脉体瘤的诊断中具有重要价值。颈动脉体瘤患者术前应常规行血管造影及TBO检查,进行系 统全面的颈动脉评价,并做好血管重建准备。确诊为颈动脉体瘤后,应尽早手术,根据肿瘤与颈动脉的关系选择适 宜术式。

关键词: 颈动脉体瘤, 血管造影, 暂时性球囊阻断试验, 多普勒检查

Abstract: Objective To study the clinical features, diagnoses and operative intervention of carotid body tumors.Methods  The medical records of 26 patientswith carotid body paragangliomas between 1993 and 2004 were retrospectively reviewed.Results  Two of twenty-six patients had bilateral tumors. One patient had malignanttumorswith cervical lymph nodesmetastases. Twen- ty-one patients were evaluated with a preoperative angiography. No preoperative embolization was performed. Eleven patients un- derwent ultrasonography, nine had CTscan of the neck, five had magnetic resonance imaging. Twenty-six patientswere all operat- ed. Vascular reconstructionwas performed in five cases. The ligation of carotid arterywas carried out in four cases and another pa- tient had vagus nerve resection. No death and recurrence occurred in all cases.Conclusion Angiography and ultrasonography are valuable in the diagnosis of carotid body tumor. Surgical removal should be made early to avoid the possibility of eventual metasta- sis and progressive local invasion. The pattern of operation should be chosed according to the relation of tumor and carotid.

Key words: carotid body tumor, angiography, temporary balloon occlusion, B ultrasonography