目的探讨颈动脉体瘤(carotid body tumor,CBT)的诊断、治疗经验和手术并发症的防治策略。方法回顾性分析2005年7月—2013年10月行手术治疗的20例颈动脉体瘤临床资料。结果本组主要表现为无痛性颈部肿物,5例伴咽部不适,2例声音低沉。均...目的探讨颈动脉体瘤(carotid body tumor,CBT)的诊断、治疗经验和手术并发症的防治策略。方法回顾性分析2005年7月—2013年10月行手术治疗的20例颈动脉体瘤临床资料。结果本组主要表现为无痛性颈部肿物,5例伴咽部不适,2例声音低沉。均曾在外院就诊,其中5例误诊,误诊为淋巴结增大原因待查3例,颈淋巴结结核2例;6例明确诊断CBT,曾行肿物活检或尝试行肿瘤切除均失败;余9例高度怀疑CBT。20例均在我院经颈部计算机断层X线血管造影(CTA)或磁共振血管造影(MRA)检查诊断为CBT,其中双侧4例,单侧16例,共24个瘤体。20例均行手术治疗,除1个瘤体延伸至颅内未完整切除外,余23个瘤体均一期手术完整切除。围手术期无死亡发生,术后出现脑神经损伤表现13例。术后共14例获得随访,11例脑神经损伤中,7例经保守治疗完全或部分恢复,4例无明显恢复。结论 CBT临床易误诊,提示临床接诊无痛性颈部肿物应考虑CBT可能,及时行颈部CTA或MRA检查有助于诊断。早期确诊并选择适当的手术方案可减少并发症的发生。展开更多
The mediastinal lymph node tuberculous abscesses（MLNTAs） are secondary to mediastinal tuberculous lymphadenitis. Surgical excision is often required when cold abscesses form. This study was aimed to examine video-as...The mediastinal lymph node tuberculous abscesses（MLNTAs） are secondary to mediastinal tuberculous lymphadenitis. Surgical excision is often required when cold abscesses form. This study was aimed to examine video-assisted thoracoscopic surgery（VATS） for the treatment of MLNTA. Clinical data of 16 MLNTA patients who were treated in our hospital between December 1, 2013 and December 1, 2015 were retrospectively analyzed. All of the patients underwent the radical debridement and drainage of abscesses, and intrathoracic lesions were removed by VATS. They were also administered the intensified anti-tuberculosis treatment（ATT）, and engaged in normal physical activity and follow-up for 3 to 6 months. The results showed that VATS was successfully attempted in all of the 16 MLNTA patients and they all had good recovery. Two patients developed complications after surgery, with one patient developing recurrent laryngeal nerve injury, and the other reporting poor wound healing. It was concluded that VATS is easy to perform, and safe, and has high rates of success and relatively few side-effects when used to treat MLNTA.展开更多
文摘目的探讨颈动脉体瘤(carotid body tumor,CBT)的诊断、治疗经验和手术并发症的防治策略。方法回顾性分析2005年7月—2013年10月行手术治疗的20例颈动脉体瘤临床资料。结果本组主要表现为无痛性颈部肿物,5例伴咽部不适,2例声音低沉。均曾在外院就诊,其中5例误诊,误诊为淋巴结增大原因待查3例,颈淋巴结结核2例;6例明确诊断CBT,曾行肿物活检或尝试行肿瘤切除均失败;余9例高度怀疑CBT。20例均在我院经颈部计算机断层X线血管造影(CTA)或磁共振血管造影(MRA)检查诊断为CBT,其中双侧4例,单侧16例,共24个瘤体。20例均行手术治疗,除1个瘤体延伸至颅内未完整切除外,余23个瘤体均一期手术完整切除。围手术期无死亡发生,术后出现脑神经损伤表现13例。术后共14例获得随访,11例脑神经损伤中,7例经保守治疗完全或部分恢复,4例无明显恢复。结论 CBT临床易误诊,提示临床接诊无痛性颈部肿物应考虑CBT可能,及时行颈部CTA或MRA检查有助于诊断。早期确诊并选择适当的手术方案可减少并发症的发生。
文摘The mediastinal lymph node tuberculous abscesses（MLNTAs） are secondary to mediastinal tuberculous lymphadenitis. Surgical excision is often required when cold abscesses form. This study was aimed to examine video-assisted thoracoscopic surgery（VATS） for the treatment of MLNTA. Clinical data of 16 MLNTA patients who were treated in our hospital between December 1, 2013 and December 1, 2015 were retrospectively analyzed. All of the patients underwent the radical debridement and drainage of abscesses, and intrathoracic lesions were removed by VATS. They were also administered the intensified anti-tuberculosis treatment（ATT）, and engaged in normal physical activity and follow-up for 3 to 6 months. The results showed that VATS was successfully attempted in all of the 16 MLNTA patients and they all had good recovery. Two patients developed complications after surgery, with one patient developing recurrent laryngeal nerve injury, and the other reporting poor wound healing. It was concluded that VATS is easy to perform, and safe, and has high rates of success and relatively few side-effects when used to treat MLNTA.
