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摘要: 目的:探讨颈静脉球体瘤及颈动脉体瘤的诊断方法和治疗经验。方法:回顾一家系4例颈静脉球体瘤及颈动脉体瘤患者的临床资料,分析其临床特点、影像学特征、手术方法和预后情况。先证者为左侧颈静脉球体瘤伴左侧颈动脉体瘤,先证者亲妹妹为右侧颈动脉体瘤,先证者堂妹为双侧颈动脉体瘤伴右侧颈静脉球体瘤,先证者堂哥为双侧颈动脉体瘤伴左侧颈静脉球体瘤。4例患者均接受全身麻醉下手术治疗。患者术前均行颈部超声、CT或CT血管造影(CTA)、MRI及数字减影血管造影(DSA)检查,3例术前行血管栓塞。结果:4例患者手术顺利,均无肢体偏瘫或死亡病例。随访24~29个月,无复发。术后半年堂哥声嘶消失,堂妹声嘶无明显好转。术后1年堂妹出现右侧周围性面瘫,颞骨CT示右侧颈静脉球体瘤。结论:颈部超声、CT、CTA、MRI及DSA是颈静脉球体瘤、颈动脉体瘤的主要影像学诊断方法,对指导治疗及制定手术方案具有重要价值。手术切除是首选的治疗方法,术前进行血管栓塞可减少术中出血,术中使用显微镜可提高术野清晰度,避免大血管及神经损伤,避免严重并发症发生。Abstract: Objective:To investigate diagnosis method and treatment experience of jugulare glomus tumor (JGT) and carotid body tumor (CBT). Method:Retrospective analysis. Clinical materials from 4 patients at one genealogy with JGT and CBT were collected. The clinical features, radiological characteristics, surgical methods and prognosis were assessed. The proband suffered from left JGT and left CBT, her younger sister had right CBT as well as her younger female cousin had bilateral CBT and right JGT,her older male cousin had bilateral CBT and left JGT. These JGT and CBT in four patients were resected under general anesthesia after preoperative ultrasound, CT or CT angiography (CTA), MRI, and digital subtraction angiography (DSA) examination as well as preoperative vascular embolization.Result:The surgery was uneventful in four cases, and there was no hemiplegia or deaths. All patients were followed up for 2 years to 29 months without recurrence. Six months after operation, the hoarseness also disappeared in the older male cousins but did not improve significantly in younger female cousin. The younger female cousin get right peripheral facial paralysis 1 year after surgery and her temporal bone CT indicated a right JGT. Conclusion:It is very important to assess JGT and CBT by Ultrasound, CT, CTA, MRI and DSA. Surgical resection is the first optional treatment for JGT and CBT. Blood loss can be reduced by preoperative vascular embolization. Serious complications could be avoid by operating under microscope, which can supply a clear surgical field and make the surgeon to protect the large blood vessels and nerve,
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Key words:
- jugulare glomus tumor /
- carotid body tumor /
- operative /
- diagnosis /
- treatment
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