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目的:总结1995～2003年期间14例颈动脉体瘤的诊治经验,探讨颈动脉体瘤术前准备、手术方法和并发症的防治。方法:14例颈动脉体瘤患者,13例术前行数字减影血管造影检查,其中11例行球囊阻断试验,1例行彩超检查。2例采用单纯瘤体切除;3例行瘤体与颈外动脉一并切除;3例行瘤体与颈内、外动脉一并切除,未做颈动脉重建;3例瘤体切除,同时行颈内动脉修补术;3例瘤体与颈内、外动脉切除,同时行颈内动脉重建。其中1例为恶性颈动脉体瘤,瘤体侵及颅底,行颈内动脉颅内、外动脉搭桥重建。结果:全部病例获随访,随访期1～9a,无复发病例。2例术后1周分别出现对侧偏瘫和失算,均在半年后康复。结论:颈动脉体瘤第一次手术应尽可能采用单纯剥除术;二次手术或恶性颈动脉体瘤需整块切除时,应尽可能行颈内动脉重建,必要时需行颅内、外动脉搭桥,以减少术后并发症。
OBJECTIVE: To summarize the diagnosis and treatment of carotid body tumor in 14 cases from 1995 to 2003, and to investigate the prevention and treatment of carotid body tumor preoperative preparation, surgical methods and complications. Methods: Totally 14 patients with carotid body tumor were examined with digital subtraction angiography before surgery. Among them, 11 patients underwent balloon occlusion test and 1 patient underwent color Doppler ultrasound examination. 2 cases were treated by simple tumor excision; 3 cases were resected with external carotid artery; 3 cases were resected together with internal and external carotid artery and did not reconstruct carotid artery; 3 cases were resected by tumor, Carotid artery repair; 3 cases of tumor and internal and external artery resection, while the internal carotid artery reconstruction. One case of malignant carotid body tumor, tumor invasion and skull base, the internal carotid artery, external artery bypass graft reconstruction. Results: All patients were followed up for 1 ~ 9 years, with no recurrence. Two cases of contralateral hemiplegia and miscalculation occurred one week after surgery, all of whom recovered after six months. Conclusions: The first surgery of carotid body tumor should be as simple as possible. In the second surgery or malignant carotid body tumor, the internal carotid artery should be reconstructed as much as possible, and if necessary, intracranial, External artery bypass to reduce postoperative complications.