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目的探讨介入联合颈内动脉转流在Ⅲ型颈动脉体瘤切除术中的应用及效果。方法回顾性分析笔者所在医院自2002年1月至2012年7月期间收治的21例(22侧)Ⅲ型颈动脉体瘤患者的临床资料。21例患者术前经充分评估后,于术前2~3 d均用微导管对供瘤血管行超选择栓塞治疗,然后在颈内动脉转流下行颈动脉体瘤切除术。结果 21例(22侧)手术均顺利完成,术后经病理学检查证实均为颈动脉体瘤。其中行颈动脉瘤切除术16例(17侧),瘤体切除+颈内动脉重建5例(其中自体大隐静脉3例,人工血管2例)。术后当天则出现神经并发症5例(舌歪3例,面部麻木2例),术后3个月内均恢复正常;无脑梗塞、偏瘫和死亡病例。21例均获随访,随访时间2个月~9年,平均57个月,无复发病例。结论颈动脉体瘤首选的治疗方式是外科切除,介入联合颈内动脉转流下切除Ⅲ型颈动脉体瘤瘤体是安全有效的。
Objective To investigate the application and effect of interventional internal carotid artery bypass in type Ⅲ carotid body tumor resection. Methods The clinical data of 21 patients (22 sides) with type Ⅲ carotid body tumor admitted to our hospital from January 2002 to July 2012 were retrospectively analyzed. Twenty-one patients were adequately evaluated preoperatively and were treated with superselective embolization of the microcatheter with a microcatheter 2 to 3 days before surgery, followed by carotid body tumor resection in the internal carotid artery bypass. Results Twenty-one cases (22 sides) were successfully performed. All the carotid body tumors were confirmed by pathological examination after operation. Among them, 16 cases (17 sides) underwent carotid aneurysm resection, 5 cases underwent resection of tumor and internal carotid artery (including 3 cases of autologous saphenous vein and 2 cases of artificial blood vessel). There were 5 cases of neurological complications (3 cases of crooked tongue and 2 cases of facial numbness) on the day after surgery, all of which returned to normal within 3 months after operation. There were no cases of cerebral infarction, hemiplegia and death. All 21 patients were followed up for 2 months to 9 years with an average of 57 months without recurrence. Conclusion The preferred treatment of carotid body tumor is surgical resection. It is safe and effective to remove type Ⅲ carotid body tumor by interventional internal carotid artery bypass.