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颈动脉体瘤临床上虽少见.但在颈部肿瘤的鉴别诊断上必须列为一项内容,警惕手术前误诊和避免手术中临时处理困难.本文对我院15年(1976~1992)9例颈动脉体瘤的诊断治疗进行了回顾性分析,其中4例院外和院内误诊,经手术探查得出正确诊断.术前超声学检查与选择性颈动脉造影能明确诊断.5例施行手术治疗者术前均采用手了法颈动脉压迫训练,促使大脑侧支循环的建立。3例行颈动脉外膜下肿瘤完全切除术,近远期疗效满意.2例切断拮扎颈总动脉,1例再结扎颈内、外动脉,肿瘤切除术;1例再结扎切断动脉分歧部,颈内、外动脉远心端端一端吻合,切除肿瘤.前者术后顺利恢复,无永久性后遗症;后者术后14天合并患侧侧脑室体旁脑梗塞,遗留有健侧轻度偏瘫,2年后随访恢复较好.作者认为术前超声检查与选择性颈动脉造影对确定诊断与颈动脉压迫锻炼准确建立大脑侧支循环是对一部分必须切除颈动脉分歧部的颈动脉体瘤手术成功的关键.
Carotid body tumors are rare in clinical practice. However, in the differential diagnosis of cervical tumor must be included as a content, vigilance misdiagnosis before surgery and to avoid temporary processing difficulties. This article retrospectively analyzed the diagnosis and treatment of 9 cases of carotid body tumors in our hospital for 15 years (1976-1992). Among them, 4 cases were misdiagnosed outside the hospital and in the hospital. Preoperative ultrasound examination and selective carotid angiography can confirm the diagnosis. Five patients who underwent surgical treatment were all subjected to manual carotid artery compression training before surgery to promote the establishment of cerebral collateral circulation. 3 cases underwent complete resection of subcarinal tumors with satisfactory results in the near and far future. In 2 cases, the common carotid artery was dissected and the internal and external carotid arteries were ligated again in 1 case. Tumor resection was performed in 1 case. In 1 case, the arterial bifurcation was resected and the distal and distal ends of the internal and external carotid artery were anastomosed to remove the tumor. The former successfully recovered after surgery without permanent sequelae; the latter was associated with lateral cerebral infarction of the lateral ventricle 14 days after surgery, leaving mild hemiparalysis on the contralateral side. The follow-up recovery was good after 2 years. The author believes that preoperative ultrasound examination and selective carotid artery angiography to determine the accurate diagnosis and carotid compression exercise to establish the accurate establishment of cerebral collateral circulation is the key to the success of surgery for a certain part of the carotid body tumor that must be resection of the carotid artery.