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耳鼻咽喉·头颈外科成功救治一名侵犯颈总动脉及颈段气管的晚期复发甲状腺癌患者 2020.07.21

JINRI,WOYUANERBIYANHOU·TOUJINGWAIKECHENFEIJIAOSHOULVTOUJINGZHONGLIUXIUFUYUZHONGJIANTUANDUICHENGGONGJIUZHILEYIMINGQINFANJINGZONGDONGMAIJIJINGDUANQIGUANDEWANQIFUFAJIAZHUANGXIANAIHUANZHE。

GAIHUANZHE5NIANJIANYINLIHUANJIAZHUANGXIANAI,XIANHOUZHANZHUANYUBEIJING、SHANGHAI、ZHEJIANGDENGDUOJIAZHIMINGYIYUAN,GONGJIESHOU5CISHOUSHUZHILIAO、2GELIAOCHENGDEI131ZHILIAO。1NIANQIANHUANZHEZHONGLIUZAICIFUFA,XINGBAXIANGZHILIAOXIAOGUOBUJIA,QIEZHONGLIUYIBAORAOBINGQINFANYOUCEJINGZONGDONGMAIJIJINGDUANQIGUANYOUCEBI。HUANZHEZAIQIANCISHOUSHUYISHENGJIANYIXIAYUWOYUANERBIYANHOU·TOUJINGWAIKECHENFEIJIAOSHOUCHUJIUZHEN。

CHENFEIJIAOSHOUTUANDUIZHENDUIWANQIFUFATOUJINGZHONGLIUDEBINGREN,NENGGOUDULIJINXINGXUEGUAN、SHENJINGZHONGJIANYIJIGEZHONGPIBANXIUFUZHONGJIANJISHU,DADAOLEGUONEIYILIU,GUOJIXIANJINSHUIPING。NENGGOUZAIBAOZHENGHUANZHEZHONGLIUWANZHENGQIECHUDEQIANTIXIA,JINKENENGHUIFUGONGNENGHEWAIGUAN,GAIBIANLEJIWANGWANQITOUJINGZHONGLIUXUYAODUOKEJINXINGHUIZHENSHOUSHUDEMOSHI,YIDINGCHENGDUSHANGJIEYUELEYILIAOZIYUAN。

图1:术前被肿瘤侵犯的动脉

SHUQIAN,CHENFEIJIAOSHOUTUANDUILIANHEMAZUIKECHENHONGYANGZHUZHIYISHIDUIHUANZHEBINGQINGJINXINGLECHONGFENPINGGU,JIUSHUZHONGJINGZONGDONGMAICHULI、NAOBUXUEGONGWEICHI、QIDAOZHONGJIANCELVE、XUNHUANWEICHIDENGGUANJIANDIANZHANKAILEDUOCITAOLUN,ZHIDINGLEYANMIDESHOUSHUFANGAN。6YUE30RI,SHOUSHUCHENGGONGQIECHULEFUFADEJIAZHUANGXIANAI、SHOUZHONGLIUQINFANBAOGUOZHANGDA8cmDEJINGZONGDONGMAI、BUFENJINGNEIJINGMAI、SUOGUXIAJINGMAI、ZHUIJINGMAIYIJIBEIQINFANDEJINGDUANQIGUANYOUCEBI。ZHONGLIUWANZHENGQIECHUHOU,ZAIJINGDONGMAIZHUANLIUGUANYOUXIAOBAOZHENGSHUCENAOXUEGUANGUANZHUDEQINGKUANGXIA,JINXINGLERENGONGXUEGUANZHIHUANZHONGJIANJINGZONGDONGMAI,XIANWEIFENGHEXIUBU/ZHONGJIANSHOULEIJINGMAI,HUIFULELUNEIWAIZHENGCHANGXUEGONG。ZUIHOU,YINGYONGYOUCEXIONGJIANFENGDONGMAICHUANZHIPIBANTONGQIXIUFULEJINGDUANQIGUANQUESUN,SHOUSHULISHI4XIAOSHI。SHOUSHUHOUHUANZHEANQUANFANHUIERBIYANHOU·TOUJINGWAIKEBINGFANG,JIESHOULEJIN1ZHOUZHILIAOHEXIXINHULI,XIANYISHUNLIKANGFUCHUYUAN。

图2:术后皮瓣重建的气管壁 图3:术后人工血管重建的颈总动脉

CHENFEIJIAOSHOUZHANGQIZHILIYUGELEIWANQI、FUFATOUJINGZHONGLIUDEWANJIUXINGSHOUSHU。QILINGDAOXIADETOUJINGZHONGLIUXIUFUYUZHONGJIANTUANDUIZHENDUIQINFANJINGXIONGBUDAXUEGUAN、QIGUAN、SHIGUAN、SHENJING、SHANGZONGGE、LUDI、KUANGNEIDETOUJINGBUWANQI/FUFAZHONGLIUJUBEICHENGSHUDEZHILIAOTIXIJIFENGFUDELINCHUANGJINGYAN。XIANGGUANJINGYANJIYANJIUCHENGGUOYIFABIAOZAI《Head & Neck》、《British journal of oral and maxillofacial surgery》DENGGUOJIZHIMINGTOUJINGWAIKEZAZHI。

作者:申恬 李林珂 编辑:史杰蔚 周亮 来源:耳鼻咽喉·头颈外科
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