鼻咽纤维血管瘤分期及供血动脉的相关研究

Correlative study on nasopharyngeal angiofibroma staging and its supply artery

目的分析不同分期的鼻咽纤维血管瘤(nasopharyngeal angiofibroma,NA)中供血动脉的来源及其影响。方法 回顾2006年7月~2017年12月在福建医科大学附属第一医院诊治的31例NA患者。按Radkowski法,Ⅰa期2例、Ⅰb期6例、Ⅱa期3例、Ⅱb期3例、Ⅱc期5例、Ⅲa期6例。术前均行数字减影血管造影(digital subtraction angiography,DSA)确定肿瘤的供血动脉,行血管栓塞,术后病理为NA。结果 31例NA,74.2%为单独颈外动脉的分支供血,25.8%为颈内、颈外动脉分支共同供血。其中,供血动脉为单独颈外动脉分支与颈内动脉分支差异有统计学意义(P<0.05)。此外,74.2%为单侧动脉供血,25.8%为双侧动脉供血,供血动脉单、双侧差异无统计学意义(P>0.05)。结论 NA临床分期与颈内外动脉分支供血相关。术前明确血供可提示肿瘤的累及程度,NA分期应将血供作为依据之一。

OBJECTIVE To explore the supply arteries in nasopharyngeal angiofibroma(NA).To study the blood supply(BS) of the internal carotid artery(ICA) branch and the external carotid artery(ECA) branch in different stages of NA.METHODS A retrospective analysis of 31 cases of NA treated in the First Affiliated Hospital of Fujian Medical University from July 2006 to December 2017.According to the Radkowski staging method,there were 2 cases in stage Ⅰa,6 cases in stage Ⅰb,3 cases in stage Ⅱa,3 cases in stage Ⅱb,5 cases in stage Ⅱc,and 6 cases in stage Ⅲa.Before the operation,DSA was used to determine the blood supply artery of the tumor,and blood supplies were embolized.All cases were confirmed with the pathological diagnosis of NA.RESULTS Of the 31 patients with NA,74.2%(23/31) were supplied with branches of the ECA alone,and 25.8%(8/31) were co-supplied with the branches of the ICA and ECA.Among the different stages of NA,the difference between the supplies from branch of the ECA and the branch of the ICA was statistically significant(P<0.05).Among the tumors with different stages,74.2%(23/31)were unilateral arterial blood supply,and 25.8%(8/31) were bilateral arterial blood supply.There was no significant difference between the unilateral and bilateral blood supply arteries(P>0.05).CONCLUSION The clinical staging of NA is related to the blood supply of ICA and ECA branches.Preoperative identification of the tumor’s blood supply can indicate the extent and extent of tumor involvement,and blood supply should also be used as a basis for NA staging.