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目的探讨侵及颈总动脉病变的手术方法及注意事项。方法分析11例资料完整的患者资料,包括喉癌喉3/4切除术后复发1例,结核性颈总动脉瘤破裂大出血1例,医源性颈总动脉瘤1例,颈动脉体瘤3例,甲状腺癌侵及颈总动脉1例,颈部肿瘤侵及颈总动脉2例,颈总动脉离断伤1例,气性坏疽1例。结果上述病例中,2例完成肿瘤切除,颈总动脉重建;2例术中应用Shunt转流管,完成肿瘤切除;1例颈外伤,行颈总动脉结扎;1例医源性颈总动脉瘤患者,行动脉瘤切除,颈总动脉修补;甲状腺癌患者分离颈总动脉并切除部分气管侧壁完成肿瘤切除及应用颈前肌气管修补;2例颈部肿瘤保留颈总动脉切除肿瘤;1例气性坏疽患者颈部切开减压。结论侵及颈总动脉病变的手术治疗,主要有下列3种形式:①切除肿瘤及颈总动脉、颈动脉重建;②切除肿瘤及颈总动脉,颈总动脉结扎;③分离颈总动脉切除肿瘤。
Objective To investigate the surgical methods and precautions of invading the common carotid artery. Methods The data of 11 patients with complete data were analyzed including 1 case of recurrent laryngeal carcinoma after 3/4 resection, 1 case of tuberculous common carotid aneurysm rupture, 1 case of iatrogenic common carotid aneurysm, 3 carotid body tumor of carotid body Cases, thyroid cancer invaded the common carotid artery in 1 case, 2 cases of neck tumor invaded the common carotid artery, common carotid artery in 1 case, gas gangrene in 1 case. Results Of the above cases, 2 cases underwent tumor resection and common carotid artery reconstruction; 2 cases were treated with Shunt tube to complete resection of the tumor; 1 case of neck trauma and ligation of common carotid artery; 1 case of iatrogenic carotid artery aneurysm The patients underwent aneurysm resection and common carotid artery repair. The common carotid arteries were removed from the patients with thyroid carcinoma and some of the tracheal resections were performed. The resection of the tumors and the repair of the anterior tracheal tube were performed. Two cases of tumors were removed from the neck of the common carotid artery. One case Gastric gangrene patients with neck incision decompression. Conclusion Surgical treatment of invading common carotid artery lesions mainly includes the following three forms: ① resection of tumor and common carotid artery and carotid artery; ② resection of tumor and common carotid artery and common carotid artery; ③ removal of common carotid artery .