成人咽喉部血管瘤23例临床分析

Clinical analysis of 23 cases of adult laryngopharyngeal hemangioma

目的探讨成人咽喉部血管瘤的临床特征、诊断、治疗方法选择及治疗效果。方法对2006年4月~2018年6月期间在江南大学附属医院耳鼻咽喉头颈外科住院诊治的咽喉部血管瘤患者的临床资料进行回顾性分析。结果23例患者,男性15例,女性8例;主要临床症状为咽部异物感、声音嘶哑及咳血,部分患者无任何症状。主要发病部位为舌根、会厌谷、杓会厌皱襞,梨状窝等,可单发,也可多发。MRI一般表现为T1WI等或低信号,T2WI高信号,增强可明显强化。15例患者采用了药物注射治疗,6例采用了手术切除,2例采用了药物注射联合射频或者低温等离子手术治疗。随访2个月~1年,治愈21例,显效2例,无严重治疗并发症。结论成人咽喉部血管瘤多发生于声门上区,多数病人无特异性症状,电子喉镜和增强MRI是主要的诊断工具,根据肿瘤部位和大小采取药物注射、手术切除或者联合治疗可取得满意效果,治疗期间需注意呼吸道的管理。

Objective To investigate the clinical characteristics,diagnosis,treatment method and therapeutic effect of adult laryngopharyngeal hemangioma.Method A retrospective review of the clinical data was carried out on 23 patients with laryngopharyngeal hemangioma from April 2006 to June 2018.Result Of the 23 cases,15 cases were male and 8 were female.The main clinical symptoms were the sensation of foreign body in the pharynx,hoarseness,hemoptysis and some of the patients have no discomfort.The main locations were tongue base,vallecula epiglottic,aryepiglottic folds,pyriform fossa,etc.,which can be single or multiple.MRI is generally expressed as equal or low signal intensity on T1-weighted image,high signal intensity on T2-weighted?image and enhanced obviously.15 patients were treated with drug injection,6 with surgical excision,and 2 with drug injection combined with radiofrequency coblation.All patients were followed up for 2 months to 1 year,21 cases were cured,2 cases were obviously effective,no serious complications occurred.Conclusion Most of the adult laryngopharynx hemangiomas occur in the supraglottic region with no specific symptoms.Electrolaryngoscope and enhanced MRI are the main diagnostic tools.Satisfactory effects can be achieved through drug injection,resection or combined treatment according to the location and size of the tumor.During the treatment,attention should be paid to the management of the respiratory tract.