摘要
目的 对颈动脉重建术在头颈外科的临床应用进行评价。方法 7例累及颈动脉的头颈部恶性肿瘤采用瘤体连同颈动脉切除与颈动脉重建术 ,术前TCD、DSA、SPECT、动脉残端压等检查 ,术中用SHUNT管分流 ,根治性颈清扫术、肿瘤及受累动脉切除、采用大隐静脉重建颈动脉、胸大肌肌 (皮 )瓣或前臂皮瓣覆盖重建动脉移植段和组织缺损区。术后 3、7、14、2 1、2 8dTCD测量颈动脉Vm、PI、RI指标值。结果 所有病例术后病情平稳、伤口无感染、肌皮瓣均成活 ,术后颈动脉彩超显示血流通畅 ,重建血管Vm、PI、RI指数正常 ,Willis环通畅 ,观察期间均末出现神经系统并发症。结论 颈动脉重建术既能给晚期头颈癌累及颈动脉患者提供一个彻底根治的机会 ,又可大大降低死亡率及神经系统并发症。
Objective To evaluation clinical application of carotid artery reconstruction in head and neck surgery.Methods A total of seven malignant head and neck carcinoma involving the carotid artery included in this clinical trail.All cases were examined by the means of TCD,DSA and SPECT to confirmed good compatibility of brain blood circulation before opration. Vm,PI,RI markers were measured with TCD on 3d,7d,14d,21d,28d before the operation and after operation.A by-pass was set up by inserting a shunt tube between the common artery and the internal carotid artery.The extended tumor resection was carried out involving the resection of carotid artery.These artery were reconstructed with great saphenous vein.Tissue defects were repaired by musculo-cutaneous flaps.Results Postoperative patient's condition were stable and none-infection.Musculo-cutaneous flaps were alive.The markers(Vm PI RI) of the internal carotid artery were normal.Willis cycle were unobstructed.There was no nervous system complication.Conclusion The reconstruction of carotid artery either provided a opportunity for involving carotid artery to bring under permanent control and reduce mortality rate and the nervous system complication.
出处
《重庆医学》
CAS
CSCD
2004年第10期1492-1493,1495,共3页
Chongqing medicine
关键词
颈动脉
重建
恶性肿瘤
carotid artery
reconstruction
malignant tumor
