颈外动脉栓塞术联合鼻内镜切除富血供鼻咽部血管纤维瘤

目的评价颈外动脉栓塞术联合鼻内镜切除术治疗富血供鼻咽部血管纤维瘤的临床疗效,并与单纯鼻内镜切除术进行对比分析。资料与方法搜集本院收治的富血供鼻咽部血管纤维瘤患者33例,其中采用颈外动脉栓塞术联合鼻内镜切除术治疗20例(A组),单纯鼻内镜切除术治疗13例(B组),回顾性分析两组病例切除术中失血量、手术时间、术后住院时间等差异,对术后1年复发情况进行随访。结果 A组切除术中失血量为(154.5±84.3)ml,手术时间为(75.0±30.9)min,术后住院时间为(3.5±1.3)天,动脉栓塞术后6例发生轻度并发症,经对症治疗后消失,随访1年有1例复发;B组切除术中失血量为(623.1±142.3)ml,手术时间为(100.8±62.2)min,术后住院时间为(5.7±2.1)天,随访1年有1例复发。结论颈外动脉栓塞术联合鼻内镜切除术是治疗富血供鼻咽部血管纤维瘤微创、安全、有效的方法,与单纯鼻内镜切除术相比,具有术中失血量少、手术时间短、术后恢复快的优势。

External Carotid Artery Embolization Combined with Transnasal Endoscopic Resection in Treatment of Nasopharyngeal Angiofibroma with Abundant Blood Supply

Objective To evaluate the clinical value of external carotid artery embolization combined with transnasal endoscopic resection in the treatment of nasopharyngeal angiofibroma with abundant blood supply,and compare with simple transnasal endoscopic resection.Materials and Methods 33 patients of nasopharyngeal angiofibroma with abundant blood supply were collected,20 patients were treated with external carotid artery embolization combined with transnasal endoscopic resection(group A),13 patients were treated with simple transnasal endoscopic resection(group B).Blood loss,operation time,postoperative hospitalization day were compared and analyzed,follow up was carried out through CT scan after 1 year.Results In group A,blood loss was(154.5±84.3) ml,operation time was(75.0±30.9) min,postoperative hospitalization day was(3.5±1.3) d,slight complications occurred in 6 cases after embolization,which were disappeared after treatment,1 case recurred in 1 year follow up,while in group B,blood loss was(623.1±142.3) ml,operation time was(100.8±62.2) min,postoperative hospitalization day was(5.7±2.1) d,1 case recurred in 1 year follow up.Conclusion External carotid artery embolization combined with transnasal endoscopic resection is a minimally invasive,safe and effective technique for nasopharyngeal angiofibroma with abundant blood supply,it has advantages of lower blood loss,shorter operation time,faster recovery after operation compared with simple transnasal endoscopic resection.