【摘要】 目的探讨数字减影血管造影(DSA)及栓塞在鼻咽部血管纤维瘤诊断和治疗中的价值。方法对16例鼻咽部血管纤维瘤进行DSA检查和选择性栓塞肿瘤供血动脉。栓塞后2～7天行鼻内镜下肿瘤切除。结果DSA检查使鼻咽血管纤维瘤获得明确的诊断,所有病例均主要由同侧的颌内动脉供血,咽升动脉参与供血1例,同侧颈内动脉参与供血1例,16例患者均栓塞成功。鼻内镜下肿瘤全切除者15例,大部分切除者1例,术中出血明显减少,术中及术后无严重并发症。结论鼻咽血管纤维瘤的数字减影血管造影能显示病变的范围、血供情况及其特征。栓塞有助于减少术中出血,提高手术安全性及全切率,为内镜下手术的必备条件。更多还原

【Abstract】 ObjectiveTo investigate the practical value of digital subtraction angiography(DSA) in the diagnosis of nasopharyngeal angiofibroma and pre-operative embolization to the main supplying artery for the surgical treatment of this lesion. Methods Sixteen cases with nasopharyngeal angiofibroma were included in this study. They were all given DSA for the diagnosis of the lesion and selected embolization to block the main supplying artery to the tumor before operation. Then,these patients were all operated on to remove the tumor under nasal endoscope after 2 to 7 days following the embolization. Results The procedure of DSA made the diagnosis of nasopharyngeal angiofibroma more definite and all of them were shown being the ipsilateral internal maxillary artery as the main supplying vessel to the tumor, except one with the ipsilateral ascending pharyngeal artery and other one with the ipsilateral internal carotid artery as the co-supplying vessel. 16 cases were all successfully blocked to the supplying artery and operated on under nasal endoscope to remove the tumor, totally excised among 15 cases and largely removed in one case.Bleeding was obviously reduced during the period of operation and no severe complications were occurred during and/or after the surgery. Conclusions DSA for nasopharyngeal angiofibroma can clearly display the invading range of this lesion,supplying arteries to the tumor and some other important features of the tumor.Selected pre-operative embolization to the supplying arteries of the tumor can largely reduce bleeding during the period of operation, improve the safety of the surgery and increase the rate of total tumor removing. All these are beneficial to the surgery performed under nasal endoscope for this kind of tumor.更多还原