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颈内动脉损伤不常见,但死亡率很高,颅底部颈内动脉穿通伤的手术暴露非常困难。近代有许多报告介绍成功地切除了颅底部的多种肿瘤,多采用下颌后、外下侧进路,也有采用下颌骨切除或切开术者。根据切除咽旁间隙和颅底部肿瘤的经验,下颌骨切开术也许是处理颅底部颈内动脉穿通伤的一种更安全更合适的途径。作者报告1例36岁女性患者,右面部枪伤并颈内动脉穿通伤,采用下颌骨切开术成功地结扎了颈内动脉的近心端和远心端。术后情况良好,无脑缺血表现。6周后下颌骨切开部愈合满意。
Internal carotid artery injury is not common, but the mortality rate is very high. It is very difficult to expose the cranial base internal carotid artery through the wound. There are many modern reports on the successful removal of a variety of tumors at the base of the skull, the use of the lower jaw, the lateral approach, there are also those who use mandibular resection or incision. Based on the experience of resection of the parapharyngeal space and cranial base tumors, mandibular incision may be a safer and more suitable approach for the treatment of penetrating traumatic carotid artery in the skull base. The authors report a 36-year-old female patient with a gunshot wound on the right and a carotid artery penetrating injury. The mandibular incision was used to successfully ligate the proximal and distal ends of the internal carotid artery. Postoperative condition is good, no cerebral ischemia performance. Mandibular incision healed satisfactorily after 6 weeks.