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目的 :探讨X线颈动脉造影对颈动脉体瘤治疗方案选择的指导作用。方法 :分析 3 3例颈动脉体瘤术前颈动脉造影、术中所见及最终手术方式 ,探讨它们之间的相关性 ,总结造影结果对制定治疗方案的指导意义。结果 :颈动脉体瘤血管造影显示肿瘤血供丰富 ,颈动脉分叉张开 ,呈握球状改变 ;血管影像清晰、动脉被推移的病例 ,肿瘤对血管侵蚀轻 ,手术完整剥除肿瘤的可能性大 ;肿瘤包绕血管 ,血管显影不清晰的病例 ,说明肿瘤对血管壁破坏严重 ,剥除肿瘤困难 ,须做好颈动脉切除及重建的准备。对于肿瘤与血管染色混杂 ,无法分清各自结构与位置的病例 ,均需行颈动脉切除。术前的颈动脉压迫训练对减少或减轻术后并发症具有重要意义。结论 :术前选择性血管造影可以明确诊断 ,判断肿瘤对血管的侵蚀程度 ,评价阻断患侧颈动脉后健侧颈动脉对颅内 ,特别是对患侧脑的供血情况 ,有助于选择手术方案 ,对于颈动脉体瘤外科治疗和减少并发症是必要的。
Objective: To explore the guiding role of X-ray carotid artery angiography in the treatment of carotid body tumor. Methods: To analyze the preoperative carotid artery angiography of 33 cases of carotid body tumor, the intraoperative findings and the final surgical approach, to explore the correlation between them, and to summarize the guiding significance of the imaging results in the development of the treatment plan. Results: Carotid body angiography angiography showed rich blood supply of the tumor, carotid bifurcation open, showing a spherical shape changes; clear vascular images, the artery is the case of the shift, the tumor on the vascular erosion light, the possibility of complete surgical removal of the tumor Large; tumor-encircling blood vessels, vascular imaging was not clear cases, indicating that the tumor on the vessel wall damage, tumor stripping difficulties, must be prepared for carotid artery resection and reconstruction. Tumor and vascular staining mixed, can not distinguish between the structure and location of the respective cases, require carotid artery resection. Preoperative carotid compression training to reduce or reduce postoperative complications is of great significance. Conclusion: Preoperative selective angiography can confirm the diagnosis of tumor to determine the degree of vascular erosion, the evaluation of the ipsilateral carotid artery after ipsilateral carotid artery on the intracranial, especially in the affected side of the brain to help the choice of blood Surgical options for the carotid body tumor surgical treatment and reduce complications is necessary.