专题研究(Monographic Study)

超选择动脉栓塞后手术切除颈动脉体瘤的疗效分析

Published at: 2016年第25卷第6期

张建彬 1,2 , 徐荣伟 1,2 , 陈洁 1 , 孔杰 1,2 , 叶志东 1 , 刘鹏 1,2
1 中日友好医院 心脏血管外科,北京 100029
2 北京协和医学院 研究生院,北京 100730
通讯作者 鹏 刘 Email: Liupeng5417@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.06.014
基金:
科技部国家国际科技合作专项基金资助项目 2013DFA31900

摘要

目的:探讨超选择动脉栓塞后手术切除颈动脉体瘤的疗效。方法:回顾中日友好医院自2007年4月―2015年9月手术治疗的26例颈动脉体瘤患者临床资料,分析其临床特点、影像学检查、治疗及预后情况,根据是否进行术前超选择栓塞分为栓塞组(9例)和未栓塞组(17例),分析并比较两组患者的相关临床指标。结果:26例(27侧)共进行26侧手术治疗。与未栓塞组比较,栓塞组平均手术时间(127.22 min vs. 158.82 min)和平均出血量(110.00 mL vs. 355.88 mL)均明显减少(均P<0.05),但两组的手术时间与出血量均随患者肿瘤严重程度(Shamblin分型)增加而成升高趋势。26例手术患者术后颈部肿物均消失,术前伴有疼痛及咽部不适者术后症状均消失,围手术期无死亡及肢体瘫痪,术后神经功能障碍7例(26.92%),均于术后6个月随访时恢复。结论:手术切除颈动脉体瘤安全可靠,是颈动脉体瘤的首选治疗,而术前超选择栓塞可以明显减少出血量,缩短手术时间。


Efficacy analysis of superselective embolization followed by surgical resection for carotid body tumors

Abstract

Objective: To evaluate the efficacy of superselective embolization followed by surgical resection in treatment of carotid body tumors. Methods: The clinical data of 26 patients with carotid body tumors treated in China-Japan Friendship Hospital from April 2007 to September 2015 were reviewed. According to whether or not they underwent preoperative superselective embolization, the patients were classified into embolization group (9 cases) and non-embolization group (17 cases). The relevant clinical variables of the two groups of patients were analyzed and compared. Results: Surgical resection was performed in 26 sides of the 26 patients (27 sides). In embolization group compared with non-embolization group, the mean operative time (127.22 min vs. 158.82 min) and intraoperative blood loss (110.00 mL vs. 355.88 mL) were both significantly reduced (both P<0.05), while both operative time and intraoperative blood loss presented an increasing tendency with increase of the severity of the tumor (Shamblin’s classification) in either group. In all the 26 patients, the neck mass disappeared and the accompanied symptoms such as pain and pharyngeal discomfort were relieved after surgery. No death or paralysis occurred during perioperative period, but nervous dysfunction occurred in 7 patients (26.92%) and, in all of them, it had recovered on follow-up 6 months after surgery. Conclusion: For carotid body tumors, surgical resection is safe and reliable, and is the first choice of treatment. Preoperative superseclective embolization can significantly reduce blood loss and shorten operative time.


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引用

引用本文: 建彬 张, 荣伟 徐, 洁 陈, 杰 孔, 志东 叶, 鹏 刘. 超选择动脉栓塞后手术切除颈动脉体瘤的疗效分析 [J]. 中国普通外科杂志, 2016, 25(6): 859-863.
Cite this article as: ZHANG Jianbin, XU Rongwei, CHEN Jie, KONG Jie, YE Zhidong, LIU Peng . Efficacy analysis of superselective embolization followed by surgical resection for carotid body tumors[J]. Chin J Gen Surg, 2016, 25(6): 859-863.