1.临沂市人民医院放射科,山东 临沂 276000
2.中山大学附属第一医院放射介入科,广东 广州 510080
孔祥国,主治医师,研究方向:肿瘤功能影像学改变,E-mail: kxgtt66@sina.com
纸质出版日期:2021-03-20,
收稿日期:2020-12-20,
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孔祥国,李楠,杨建勇等.术前经导管动脉栓塞对Shamblin Ⅱ/Ⅲ型颈动脉体瘤切除术的影响[J].中山大学学报(医学科学版),2021,42(02):287-293.
KONG Xiang-guo,LI Nan,YANG Jian-yong,et al.Beneficial Effects of Preoperative Embolization on the Shamblin Type Ⅱ/Ⅲ Carotid Body Tumor Surgery[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(02):287-293.
孔祥国,李楠,杨建勇等.术前经导管动脉栓塞对Shamblin Ⅱ/Ⅲ型颈动脉体瘤切除术的影响[J].中山大学学报(医学科学版),2021,42(02):287-293. DOI:
KONG Xiang-guo,LI Nan,YANG Jian-yong,et al.Beneficial Effects of Preoperative Embolization on the Shamblin Type Ⅱ/Ⅲ Carotid Body Tumor Surgery[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(02):287-293. DOI:
目的
2
探讨术前经导管动脉栓塞(Pre-TAE)对Ⅱ/Ⅲ型颈动脉体瘤(CBTs)外科切除术的影响。
方法
2
回顾性分析2010年1月至2020年1月我院收治的影像及病理确诊的Ⅱ/Ⅲ型CBTs患者为研究对象,根据是否行Pre-TAE将患者分为栓塞组及未栓塞组。分析并比较两组患者临床资料、手术方式、术中出血量、手术时间、并发症等相关指标。
结果
2
本研究共纳入100个病灶(栓塞组
n
=77,未栓塞组
n
=23)。栓塞组与未栓塞组肿瘤大小分别为(Ⅱ: 40.91
vs
. 37.32 mm,
P
>
0.05; Ⅲ: 63.58
vs.
65.75 mm,
P
>
0.05)。术中出血量以及手术时间分别为(Ⅱ:100
vs
. 100 mL,
P
>
0.05;Ⅲ:750
vs
. 1 000 mL,
P
>
0.05) 、(Ⅱ: 184.66
vs
. 230.74 mins,
P
>
0.05; Ⅲ: 288.50
vs
. 332.75 mins,
P
>
0.05)。尽管Pre-TAE能减少Ⅱ/Ⅲ型CBTs术中血管重建率(Ⅱ: 28%
vs
. 32%,
P
>
0.05;Ⅲ:58%
vs
. 100%,
P
>
0.05),但其差异无统计学意义。Ⅱ/Ⅲ型CBTs栓塞组手术并发症明显低于未栓塞组,其差异无统计学意义(Ⅱ: 22%
vs
. 47%,
P =
0.026; Ⅲ: 50%
vs.
75%,
P
>
0.05)。
结论
2
术前栓塞CBTs可有效降低术中失血量,改善手术视野可视化,从而有利于ShamblinⅡ/Ⅲ级CBTs的手术切除,减少手术时间,减少术中血管重建可能及手术并发症。
Objective
2
To investigate the feasibility and efficacy of preoperative arterial embolization (Pre-TAE) on Ⅱ/Ⅲ carotid body tumors (CBTs) surgical resection.
Methods
2
This retrospective study reviewed 100 cases of CBTs in the First Affiliated Hospital, Sun Yat-sen University from Jan 2010 to Jan 2020, which underwent surgical resection for CBTs. According to whether receiving the pre-TAE, the patients were classified into the embolization group (EG) and non-embolization group (NEG). Tumor classification was performed as the Shamblin classification. The demographic, clinical features, and the operative and post-operative information about the patients were retrieved from the patient records.
Results
2
The average tumor sizes were (Ⅱ: 40.91
vs
. 37.32 mm,
P
>
0.05; Ⅲ: 63.58
vs
. 65.75 mm,
P
>
0.05) for EG and NEG. The mean operative time (Ⅱ: 184.66
vs
. 230.74 mins,
P
>
0.05; Ⅲ: 288.50
vs
. 332.75 mins,
P
>
0.05) and intraoperative blood loss (Ⅱ: 100
vs
. 100 mL,
P
>
0.05; Ⅲ: 750
vs
. 1 000 mL,
P
>
0.05) were less in the EG patients. The incidence of revascularization required (Ⅱ: 28%
vs
. 32%,
P
>
0.05; Ⅲ: 58%
vs
. 100%,
P
>
0.05) and total complications (Ⅱ: 22%
vs
. 47%,
P
=0.026; Ⅲ: 50%
vs.
75%,
P
>
0.05) were lower in the EG when compared with NEG.
Conclusions
2
CBTs can be surgically resected safely and effectively with a need for pre-TAE. Resection patients who received pre-TAE had lower blood loss and shorter duration of operation. The rates of adverse events, revascularization were also lower for patients who had pre-TAE compared to those who did not. The larger the tumor size, the greater the surgical benefit of pre-TAE.
颈动脉体瘤术前经导管动脉栓塞Shamblin分级外科手术切除
carotid body tumorpreoperative transarterial embolizationShamblin classificationsurgical resection
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