颈动脉体瘤动脉内栓塞治疗的临床探讨.DOCVIP

临床医学论文-颈动脉体瘤动脉内栓塞治疗的临床探讨 　　　　　　　　　　作者：陈伟 庄文权 杨建勇 初建平 张翎 黄勇慧 郭文波 李家平 王于 【关键词】? 颈动脉体瘤 　　【摘要】 目的 探讨颈动脉体瘤动脉造影及栓塞的意义。方法 对13例经病理证实的颈动脉体瘤进行动脉内栓塞治疗，栓塞后行手术切除，并与单纯手术病例相对照。结果 动脉栓塞组术野清楚，出血少，肿瘤容易剥离，瘤体剥离率达45%，一期切除达100%，取得较好效果。随访2个月～5年，均未出现脑缺血症状，彩超复查移植血管通畅。出血量统计，动脉栓塞组平均出血量为（325±170）ml，单纯手术组平均出血量为（650±300）ml，两组比较差异有非常显著性（P0.01）。结论 动脉内栓塞作为颈动脉体瘤的手术前治疗方法，可以使出血减少、术野清晰，肿瘤分离顺利，可以达到提高疗效、减少术后并发症以及预后较好的作用。??? 　　关键词 颈动脉体瘤 动脉栓塞 临床探讨???? 　　Clinical study of transartery embolization in carotid-body tumor?? 　??? 【Abstract】 Objective To evaluate the value of pre-operative intravascular angiography and embolization in carotid-body tumor.Methods 13cases pre-operative arterography and embolization were performed in the patients with carotid-body tumor and compared with simple surgical resection.Results Pre-operative embolization made the surgical procedure easier and less bleeding.Entire ablation of the lesion was obtained in45%cases，and the resecˉtion was successful in a single surgical procedure in all cases.The blood lost was（325±170）ml in the group of pre-operative embolization，while in the group of simple surgical was（650±300）ml.Statistical manifestation was reˉvealed between the two groups（P0.01）.In pre-operative embolization group no patient had symptoms of ischemiˉa，and patency of the grafts were proved by colored Doppler ultra-sonography in2months’to5years’follow-up.Conclusion Intra-arterial embolization as a pre-operative interventional treatment of the carotid body tumor，makes the following surgical procedure easier and safer，reducing the complications and improving the prognosis as well. 　　Key words carotid-body tumor transartery embolization clinical study?? 　　颈动脉体瘤是一个少见的化学感受器肿瘤，生长于颈动脉分叉部，其血运丰富，与颈动脉粘连紧密，手术出血多、难度大。我们从1997～2002年随机对13例颈动脉体瘤进行动脉内栓塞治疗，栓塞后进行手术切除，并与26例未栓塞的病例相对照，目的是探讨颈动脉体瘤动脉造影及栓塞的意义，结果动脉栓塞组取得较好效果。 　　1 资料与方法 ??? 1.1 一般资料 1997～2002年我院收治行动脉栓塞的颈动脉体瘤共13例，男5例，女8例，年龄21～48岁，平均30岁。病史1～12年，临床表现主要是颈部肿块，多为无痛性或无自觉不适。查体:颈部表面光滑，无压痛，压迫时可缩小，松压后大小恢复。动脉栓塞组行肿瘤动脉栓塞后1～15天行手术切除。单纯手术组为1954～2002