山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (1): 53-55.doi: 10.6040/j.issn.1673-3770.0.2017.524

• ·论著· • 上一篇    下一篇

颈根部占位性病变的诊断与治疗

姜震,雷大鹏,刘大昱,孙睿杰,于学民,李学新,林云,潘新良   

  1. 山东大学齐鲁医院耳鼻咽喉头颈外科, 山东 济南 250012
  • 收稿日期:2017-12-15 出版日期:2018-01-20 发布日期:2018-01-20
  • 通讯作者: 潘新良. E-mail:panxinlent@126.com

Diagnosis and treatment of cervical root space-occupying lesions

JIANG Zhen, LEI Dapeng, LIU Dayu, SUN Ruijie, YU Xuemin, LI Xuexin, LIN Yun, PAN Xinliang   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2017-12-15 Online:2018-01-20 Published:2018-01-20

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摘要： 目的 探讨位于颈根部占位性病变的诊断,选择较佳的手术方案,并减少手术并发症的发生。 方法 收集2005年1月至2014年1月在山东大学齐鲁医院耳鼻咽喉科住院手术并经病理确诊的147例患者的临床资料并进行分析。 结果 147例患者经术后病理结果确诊,其中颈段食管癌56例、胸骨后甲状腺50例、气管肿瘤9例、神经纤维鞘瘤18例、神经纤维瘤9例、淋巴导管囊肿5例。146例患者均行手术完整切除,1例淋巴管囊肿因粘连严重未能全部切除。24例(16.33%)患者发生手术并发症。随访3年,恶性肿瘤患者3年存活率35.62%,良性病变均无瘤生存(除1例未完整切除患者)。 结论 颈根部占位性病变的首选治疗方案以手术最佳,颈根部解剖结构复杂,手术难度较大,术后并发症较多。

关键词: 占位性病变, 外科手术, 颈根部

Abstract: Objective To explore the diagnosis of lesions occupying the root of neck, choose rational surgical plans, and reduce the occurrence of complications. Methods From January 2005 to January 2014, a total of 147 patients with intact data of tumors at the root of the neck, from the Qilu Hospital of Shandong University, were retrospectively analyzed. Results According to pathologic diagnosis, 56 of the 147 cases were esophageal carcinoma, 50 were substernal thyroid, 18 were neurinoma, nine were neurofibroma, five were cyst of the lymph-vessel, and nine were tracheal tumors. All tumors were totally resected except for one lymphatic cyst, which was incompletely resected because of conjunction with important tissues.Twenty-four of the 147 cases presented complications(16.33%). Follow up for three years.The three-year survival rate for patients with malignant tumors was 35.62%. One patient with a lymphatic cyst that was not removed completely did not experience relapse. Conclusion The best therapeutic regimen for the treatment of lesions occupying the root of neck was operation, however the complicated anatomical structure of this region makes it difficult to perform operations without resulting complications.

Key words: Occupied lesions, Surgical procedures, operative, Root of the neck

中图分类号: 

  • R768
[1] Ugalde P, Miro S, Frechette E, et al. Correlative anatomy for thoracic inlet; glottis and subglottis; trachea, carina, and main bronchi; lobes, fissures, and segments; hilum and pulmonary Vasculal-system; bronchial arteries and lymphatics[J]. Thorac Surg Clin, 2007, 17(4):639-659.
[2] Carrier G, Frechette E, Ugalde P, et al. Correlative anatomy for the sternum and ribs. costovertebral angle. chest wall muscles and intercostal spaces, thoracic outlet[J]. Thorac Surg Clin, 2007, 17(4):521-528.
[3] Fellmer PT, Bohner H, Wolf A, et al. A left nonrecurrent inferior laryngeal nerve in a patient with right-sided aorta, truncus rteriossus communis and an aberrant left innominate artery[J]. Thyroid, 2008, 18(6):647-649.
[4] 张蕴,杜红文,付和睦,等. 原发纵隔囊肿影像学表现[J]. 实用放射学杂志,2007,23(12):1614-1616. ZHANG Yun, DU Hongwen, FU Hemu, et al. Imaging features of primary mediastinal cysts[J]. J Prac Radiol, 2007, 23(12):1614-1616.
[5] 赵敬柱,于洋,李亦工,等. 胸骨后甲状腺肿瘤的外科治疗[J]. 中国肿瘤临床,2013,40(13):796-798. ZHAO Jingzhu, YU Yang, LI Yigong, et al. Surgical management of substernal thyroid neoplasms[J]. Chin J Clin Oncol, 2013, 40(13):796-798.
[6] 吴跃煌,祁永发,唐平章,等. 胸骨后甲状腺肿的手术径路[J]. 中华耳鼻咽喉头颈外科杂志,2006,41(7):528-531. WU Yuehuang, QI Yongfa, TANG Pingzhang, et al. Surgical approach for intrathoracic goiter[J]. Chin J Otorhinolaryngol Head Neck Surg, 2006, 41(7):528-531.
[7] Hedayati N, Christopher R. The clinical presentation and operativemanagement of nodular and diffuse substernal thyroid disease[J]. Am Surg, 2002, 68(3):245-251.
[8] 葛俊恒. 胸骨后甲状腺肿瘤34例的外科治疗[J]. 中华普通外科杂志,2003,18(4):227-228. GE Junheng. Surgical management of substernal goiter[J]. Chin J General Surg, 2003, 18(4):227-228.
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