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目的 :探讨颈部恶性肿瘤侵及双侧颈内静脉可否一期切除双侧颈内静脉提高肿瘤切除的彻底性并避免二次手术。方法 :总结 1 992至 1 998年 5例保留颈前静脉及颈外静脉一期切除双侧受颈部恶性肿瘤侵及的颈内静脉的临床资料 ,5例中喉癌 4例 ,下咽癌 1例。结果 :双侧颈内静脉结扎的 5例全部保留双侧颈外静脉及颈前颈脉 ,结扎切除双侧颈内静脉。术后 2 4 h内面部稍肿胀 ,4～ 6d肤色转为正常 ,无严重并发症出现。5例患者随访 5～ 1 8个月。存活 1 8个月 2例 ,1 0个月 1例 ,8个月 1例 ,死亡原因为癌复发及颈动脉破裂。1例随访 6个月 ,健在 ,偶有头晕及直立性晕厥。结论 :保留颈前静脉及颈外静脉一期结扎双侧颈内静脉是可行的。
Objective: To investigate whether the invasion of bilateral cervical internal jugular neoplasms and neck internal jugular vein can double-sided jugular vein resection to improve the completeness of tumor resection and to avoid secondary surgery. Methods: From January 1992 to January 1998, 5 cases of internal jugular vein with bilateral neoplasms invading the cervical neck were treated by one-stage resection of the anterior and external jugular veins. Among the 5 cases, 4 were laryngeal carcinoma, hypopharyngeal carcinoma 1 case. Results: All the bilateral jugular vein and anterior cervical carotid artery were preserved in 5 cases of bilateral jugular vein ligation, and the bilateral internal jugular vein was excised and ligated. Within 24 hours after operation, the face was slightly swollen and the color of skin became normal after 4 ~ 6 days without serious complications. Five patients were followed up for 5 ~ 18 months. 2 cases survived 18 months, 1 case at 10 months and 1 case at 8 months. The causes of death were cancer recurrence and carotid artery rupture. One case was followed up for 6 months, alive, occasional dizziness and erection syncope. Conclusion: It is feasible to retain the anterior and posterior jugular vein of the jugular vein.