鼻咽纤维血管瘤内窥镜切除术前动脉栓塞治疗的临床评价

Clinical Evaluation of Intra-Arterial Embolization for Nasopharyngeal Fibroangioma before Endoscopic Resection

目的通过对照研究探讨鼻咽纤维血管瘤术前栓塞治疗的临床价值。方法32例鼻咽纤维血管瘤患者,男24例,女8例。年龄15～72岁,平均33岁。15例内窥镜下切除术前行供血动脉栓塞,栓塞物为栓塞颗粒;17例直接行手术切除。结果栓塞后90%肿瘤血供消失,栓塞组与未栓塞组平均术中出血量分别为375.33±252.07ml和1202.94±681.32ml,两组差异有显著统计学意义(P<0.05)。两组患者住院天数分别为10.73±2.25天和9.23±2.13天,两组差异无显著性统计学意义(P>0.05)。结论鼻咽纤维血管瘤术前栓塞治疗可有效减少术中出血,保证肿瘤完整切除。

Objective To evaluate the clinical value of preoperative intra-arterial embolizam in the surgical treatment of nasophayngeal fibroangioma. Methods Thirty-two patients with nasophayngeal fibroangioma aged 15 to 72 years old （mean thirty-three）.Among them, fifteen patients were preformed angiography and intra-arterial embolism and the other seventeen cases were operated with endoscopic directly as control group. The arteries of supplying blood were from the maxillary branch of the external carotid artery, which were embolized with particulate embolic agents, Results The blood supplies of 90% in embolized patients were completely blocked. The averaged volume of blood losing during the operation was 375. 33±252.07ml in the embolism group while it was 1202.94±681.32ml in the control group,with a very significant difference between the two groups （ P〈 0. 05）.The averaged hospital day was 10.73±2.25 d and 9.23±2.13,there is no significant difference between the two groups （P〉0.05） .Conclusion Preoperative internal maxillary artery embolism is very beneficial for the surgical resection of nasopharyngeal fibroangioma.