鼻咽部血管纤维瘤术前动脉栓塞的临床应用价值

Preoperative external carotid artery embolization of nasopharyngeal angiofibroma:its clinical application

目的评价超选择性颈外动脉栓塞术在鼻咽部血管纤维瘤经鼻内镜切除术前的临床应用价值。方法对20例鼻咽部血管纤维瘤患者经鼻内镜切除术前1～3d行超选择性颈外动脉分支,供血动脉栓塞术,回顾性分析术中出血、手术时间及并发症等情况。结果 20例患者均成功接受超选择性颈外动脉栓塞术,1～3d后行经鼻内镜切除术,平均术中出血155ml,平均手术时间为75min,栓塞术后6例发生轻度并发症,经对症治疗后消失。切除术后无严重并发症发生,术后平均住院时间为3.5d。结论超选择性颈外动脉栓塞术可明显减少鼻咽部血管纤维瘤术中出血和术后并发症,有效缩短手术时间,联合经鼻内镜切除术是鼻咽部血管纤维瘤微创、有效的治疗手段。

Objective To evaluate superselective external carotid artery embolization before transnasal endoscopic resection in treating nasopharyngeal angiofibroma.Methods Superselective external carotid artery embolization was performed in 20 patients with nasopharyngeal angiofibroma one to three days before transnasal endoscopic resection was carried out.The clinical data,including the volume of blood loss during the surgery,the operative time and the complications,were retrospectively analyzed.Results Superselective external carotid artery embolization was successfully preformed in all 20 patients,which was followed by the transnasal endoscopic resection within 3 days.The average volume of blood loss during the surgery was 155 ml and the total time of operation was 75 minutes.Mild complications occurred in 6 patients after embolization,which were subsided after symptomatic management.No serious complications occurred after surgical resection.The mean hospitalization days of the patients were 3.5 days.Conclusion Preoperative superselective external carotid artery embolization of nasopharyngeal angiofibroma can markedly reduce the blood loss during surgical resection,apparently shorten the operative time and effectively lower the occurrence of complication after the operation.Superselective external carotid artery embolization combined with transnasal endoscopic resection should be regarded as an ideal therapy for nasopharyngeal angiofibroma.