鼻咽纤维血管瘤术前供血动脉栓塞的临床价值探讨

目的　探讨鼻咽纤维血管瘤术前栓塞的临床价值。方法　 2 9例鼻咽纤维血管瘤 ,其中 2 0例行IADSA及栓塞 ,9例直接手术切除 ,供血动脉主要为颈外动脉的颌内和 /或咽升动脉 ,栓塞物为明胶海绵。结果　栓塞后 90 %肿瘤血供完全消失 ,未行栓塞与栓塞后手术平均出血量分别为 115 0ml、80 0ml和 45 0ml、3 0 0ml,二者差异显著 (P <0 .0 5 )。栓塞后 14例瘤体不同程度缩小 ,6例无变化 ,15例瘤周水肿明显 ,栓塞后 48～ 72h手术最为理想。结论　鼻咽纤维血管瘤术前栓塞是临床有效的治疗方法之一。

Clinical Value of Preoperative Intra-Arterial Embolism for Nasopharyngeal Fibroangioma

Purpose To evaluate the clinical value of preoperative intra arterial embolism in the surgical treatment of nasopharyngeal fibroangioma. Methods Twenty of 29 cases with nasopharyngeal fibroangioma were performed angiography and intra arterial embolism and the other 9 cases were operated on directly.The arteries of supplying blood were from the maxillary branch and/or the pharyngeal ascending rising from external carotid artery,which were embolized with gelatin sponge. Results The blood supplies of 90% in embolized patients were completely blocked. Average bleeding quantities of embolism and directly operation were respectively 1150ml,800ml and 450ml,300ml ( P <0.05).There were tumors shrinking in 14 cases,no changes in six cases and edema surrounding the tumers in 15 cases.Optimum time for the operation was from 48 to 72 hours after the embolism.Conclusion Preoperative intra arteral embolism for nosopharyngeal fibroangioma is a valuable method for the clinical treatment.