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1 mm×1 mm×10 mm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50～6 000 mL，平均（1 636.22±1 529.79） mL；未栓塞组有术中出血量记录者12例，出血量500~3 900 mL，平均（2 816.67±1 154.31） mL，两组差异有显著统计学意义（P＜0.05）。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。
Abstract
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 retrospectively． Among them, 39 patients(surgical operation for 51 times) had superselective external and internal carotid angiographic 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 embolization group. The other 17 patients(surgical operation for 28 times) were operated directly as non-embolization group. Results: 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 preoperative embolization of nasopharyngeal angiofibroma can reduce bleeding during operation, thus can improve the safety of the operation. It should be one of the crucial preoperation measures.
关键词
血管纤维瘤 /
鼻咽肿瘤 /
栓塞 /
治疗性
Key words
Angiofibroma /
Nasopharyngeal neoplasms /
Embolism /
therapeutic
陈济铭;万仁均;郑 惠.
鼻咽纤维血管瘤术前动脉栓塞的临床应用[J]. 中国临床医学影像杂志. 2013, 24(1): 1-4
CHEN Ji-ming;WAN Ren-jun;ZHENG Hui.
Application of transcatheter arterial embolization in nasopharyngeal angiofibroma before operation[J]. Journal of China Clinic Medical Imaging. 2013, 24(1): 1-4
中图分类号：
Ｒ739.63
R730.262
Ｒ815
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