鼻咽血管纤维瘤术前供血动脉栓塞的临床应用

目的探讨鼻咽血管纤维瘤术前供血动脉栓塞的临床应用价值。方法7例患者,确诊为鼻咽血管纤维瘤。为控制术中出血,采用Seldinger技术,行供血动脉造影及栓塞治疗。栓塞剂为明胶海绵、PVA颗粒。另选7例为术前未行供血动脉栓塞直接手术切除的鼻咽血管纤维瘤患者作为对照组,对术中出血、输血量作比较。结果7例行供血动脉栓塞患者术中出血量及输血量明显减少,两者比较差异有显著性;手术见瘤周水肿明显,易于剥离。结论鼻咽血管纤维瘤术前供血动脉栓塞术对于减少术中出血具有明显疗效。

Clinical application of preoprative TAE in the nasopharyngeal angiofibromas

Objective To evaluate the clinical value of the preoperative intra-arterial embolization of the nasopharyngeal angiofibromas. Methods The treatment group of 7 male patients with the nasopharyngeal angiofibromas were undergone angiographic evaluation and embolization of tumor-feeding vessels before surgery. All patients were embolized with gelfoam particles and PVA. The control group of 7 patients received surgical treatment without preoperative embolization. We compared the volumes of intraoperative bleeding and the blood transfusions during oprations between the two groups. Results All patients achieved symptomatic remission,with no complications. Comparing with the control group,the amount of intraoperative bleeding and the blood transfusions during operations were much less in the treatment group submitted to endovascular embolirzation.Marked edema in the peripheral region of tumor of the treatment group made the tumor easy to be dissociated. Conclusion The intraoperative bleeding can be reduced significantly by preoperative embolization of supplying arteries to the nasopharyngeal angiofibromas,therefore it should be used routinely as an adjunct to surgery. (J Intervent Radiol,2006,15: 345-347)