降低内窥镜下鼻咽纤维血管瘤手术中出血的措施——术前DSA血管栓塞方法的选择  

Reduce the Loss of Blood in Surgery for Nasopharyngeal Angiofibroma:the Experience of Preoperative Intrartery Embolization.

作　　者：张勤修[1] 刘世喜[2] 覃纲[2] 

机构地区：[1]成都中医药大学附属医院耳鼻咽喉科,四川成都610075 [2]四川大学华西医院耳鼻咽候科,四川成都610041

出　　处：《四川医学》2006年第11期1108-1109,共2页Sichuan Medical Journal

基　　金：四川省自然科学基金(05JY029-011)

摘　　要：目的 探讨鼻咽纤维血管瘸术前DSA血管栓塞经验。方法 4例鼻咽纤维血管瘸患者，1例术前采用NBCA、另3例用PVA在数字减影血管造影（DSA）下行瘸体永久栓塞，3d后在鼻内窥镜下手术切除。结果 全部病例均1次栓塞成功。在内镜下手术切除肿瘤耗时10—30min，术中出血量150～300ml，明显低于明胶海绵栓塞病例。术后CT检查提示肿瘤切除彻底。结论 鼻咽纤维血管瘸术前永久栓塞可明显减少术中出血量，优于国内普遍采用的明胶海绵暂时性栓塞。Objective To evaluate the experience of intrartery Embolization under DSA before the surgery for nasophayngeal angiofibroma. Methods There were four patients of nasophayngeal angiofibroma which were embolized permanently preoperatively. One of them was embolized with gelatin sponge under DSA and 3 days after NBCA（N-butyl-2-cyanoacrylate）were injected directly into the tumor in the operation, the other 3 patients embolized with PVA（ pelyvinyl alcohol）.The surgery was performed with the nasal endoscope after three days. Results All cases were one-stage emboLized successfully. It took ten to thirty minutes to excise the tumor by the nasal endoscope.The blood loss was 150 - 300ml,which was less than the cases who were embolized onl with gelatin spenge. CT was done after surgery and it indicated the tumor had been excised completely. Conclusion The preoperative permanent embolization was better than the temporary embolization with gelatin sponge because it can reduce the blood loss obviously.

关 键 词：鼻咽纤维血管瘸 手术 鼻内窥镜 数字减影血管造影(DSA)血管栓塞术 

分 类 号：R739.63[医药卫生—肿瘤]