鼻咽部纤维血管瘤术前血管栓塞的临床应用
Clinical Application of Preoperative Intra Arterial Embolism for Nasopharyngeal Fibroangioma
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摘要: [摘要]目的 探讨鼻咽部纤维血管瘤术前血管造影表现和血管栓塞治疗的临床应用价值.方法 采用Seldinger技术,经股动脉入路,分别进行双侧颈内外动脉及椎动脉血管造影;根据造影结果,采取超选择插管对肿瘤颈外系统供血动脉进行栓塞,栓塞后7d内行手术切除.结果 11例患者,患侧颌内动脉分支供血7例,双侧颌内动脉分支供血2例, 患侧颌内动脉及咽升动脉分支供血1例,患侧颌内动脉及颈内动脉分支供血1例;所有患者颈外动脉供血分支超选择性栓塞均获得成功;栓塞后均未发生严重并发症;栓塞后,11例7 d内行手术切除,术中出血少,手术平均出血约300 mL.结论 血管造影和血管栓塞治疗鼻咽部血管瘤是一种安全有效的术前辅助治疗方法.Abstract: [Abstract]Objective To discuss preoperative digital subtract angiography and the clinical value of intra arterial embolization in the nosepharyngerl fibroangioma before surgical treatment.Methods Seldinger technology was used to conduct the bilateral internal and external carotid artery and vertebral artery angiography in the femoral artery.The blood supply artery of nosepharyngerl fibroangioma from external carotid artery was embolized by suerselective embolization,and the fibroangioma was removed 7 days after embolization.Results The tumor blood from the same lateral internal axillary artery was found in 7 patients,from the bilateral internal axillary artery was in 2 patients,from the same lateral internal axillary and pharyngeal artery was in 1 patient,and from the same lateral axillary artery and the branches of the internal carotid artery was in 1 patient.All patients whose branches of external carotid artery were given superselective embolization and had no serious complications.The 11 patients were given the operation after embolization and the bleeding from the tumor was sgnificantly reduced in the operation and the mean bood loss was 300 mL.Conclusion Digital subtract angiography and intrabascular emblolization is a safe and effective method in treatment of nosepharyngerl fibroangioma before surgical treatment.
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