颌骨中央性血管瘤的诊断和治疗(附4例报告)

Diagnosis and treatment of central hemangioma of the jaws:a report of 4 cases

目的 探讨颌骨中央性血管瘤的诊断和治疗方法及急症止血措施。 方法 对 1984～ 1999年收治的 4例并结合文献予临床分析。 结果 病变部位：上颌骨 2例，下颌骨 2例，同时合并上唇龈颊软组织血管瘤 1例，均经手术治愈。拔牙后大出血先行急诊止血 1例，上颌骨部分切除 2例，下颌骨部分切除一期成形 2例；双颈外动脉及同侧颈总动脉结扎术 1例，选择性颌内动脉栓塞、颈外动脉结扎 1例。 结论 发生于上颌骨者，手术难度及术中出血量均明显大于下颌骨者，拔牙后出现难控制、致命性大出血应考虑本病； DSA及超选择性颌内动脉栓塞术有助于明确病灶的血供情况及减少术中出血；手术切除是本病唯一的根治方法；低温麻醉及自体血回输可减少出血量及输血并发症。

Objective To find the diagnosis,treatment and emergency measures of hemostasis of central hemangioma in jaws(CHJ). Methods Four clinical cases of CHJ from 1984～ 1999 were analyzed. Results of 4 cases,the mandible and maxilla were affected in 2 cases respectively.One of them was accompanied with the hemangioma of soft tissues in the lip,gum and cheek.The patients were cured with the resection of jaw,the ligation of external/total carotid artery,and transcatheter arterial embolization(TCAE) and mandibularplasty. Conclusion CHJ is rare and difficult in diagnosis before operation.Surgical operation is an only treatment.The amount of bleeding during operation may be decreased by TCAE and hypothermic anesthesia.