摘要
目的：探讨鼻咽纤维血管瘤术前栓塞的临床价值。材料与方法：回顾性分析56例鼻咽纤维血管瘤患者临床资料。其中39例（51次手术）术前均行双侧颈内、外动脉及椎动脉造影，明确肿瘤血供后，用明胶海绵微粒栓塞颈外动脉供养血管网，在此基础上再以1mm×1mm×10mm明胶海绵条或弹簧圈栓塞供血动脉主干，栓塞后1～3天手术切除肿瘤（栓塞组）；17例（28次手术）直接行手术切除肿瘤（未栓塞组）。结果：栓塞组术前血管造影中见到丰富的肿瘤血管网、肿瘤染色。栓塞后造影复查，所有被栓塞血管供养区域肿瘤血管网及肿瘤染色消失、供血动脉主干闭塞，无严重并发症。栓塞组有术中出血量记录者37例，出血量50-6000mL，平均（1636．22＋1529.79）mL；未栓塞组有术中出血量记录者12例，出血量500-3900mL，平均（2816．67＋1154．31）mL，两组差异有显著统计学意义（P〈O．05）。结论：鼻咽纤维血管瘤术前栓塞能减少术中出血，增加手术的安全性，是理想的术前辅助治疗手段。
Objective： To assess the clinical value of preoperative embolization for nasopharyngeal angiofibroma. Materials and Methods： Fifty-six patients with nasopharyngeal angiofibroma confirmed by surgery and pathology were analyzed retro- spectively. Among them, 39 patients （surgical operation for 51 times） had superselective external and internal carotid angio- graphic diagnosis and occluding the terminal branches of the feeding arteries of the tumor from the external carotid artery with particles of liquidized gelfoam, these patients underwent surgery in 1 to 3 days after embolization were set as the em- bolization group. The other 17 patients（surgical operation for 28 times） were operated directly as non-embolization group. Re- suits： During angiography, a large amount of vascularity and tumor staining were found in the area of tumor in the embolism group. The arteries of supplying blood were from the maxillary branch and/or the pharyngeal ascending br. rising from external carotid artery, which were embolized without serious complications. The average bleeding volume during the operatiom was （1 636.22＋1 529.79） mL（range 50-6 000 mL） in the embolization group, while it was （2 816.67＋1 154.31） mL（range 500-3 900 mL） in the non-embolization group, with a very significant difference （P〈0.05） between the two groups. Conclusion： The preopera- tive embolization of nasopharyngeal angiofibroma can reduce bleeding during operation, thus can improve the safety of the op- eration. It should be one of the crucial preoperation measures.
出处
《中国临床医学影像杂志》
CAS
2013年第1期1-4,8,共5页
Journal of China Clinic Medical Imaging
关键词
血管纤维瘤
鼻咽肿瘤
栓塞
治疗性
Angiofibroma
Nasopharyngeal neoplasms
Embolism, therapeutic
