局部穿刺栓塞进展期青少年鼻咽纤维血管瘤  

Direct puncture embolization for the treatment of advanced juvenile nasopharyngeal angiofibroma

作　　者：吕明明[1] 范新东[2] 苏立新[1] 陈东[3] 

机构地区：[1]上海交通大学医学院附属第九人民医院放射科,200011 [2]上海交通大学医学院附属第九人民医院口腔颌面外科,200011 [3]上海交通大学医学院附属第九人民医院五官科,200011

出　　处：《介入放射学杂志》2010年第10期772-775,共4页Journal of Interventional Radiology

摘　　要：目的探讨局部直接穿刺栓塞在青少年鼻咽纤维血管瘤(JNA)术前辅助性栓塞治疗中的临床应用价值。方法 29例JNA患者均行颈动脉造影明确肿瘤供血动脉。然后经皮直接穿刺到肿瘤内,注射组织胶栓塞瘤腔。结果 29例患者造影显示由颈内、颈外动脉双重供血。经局部直接穿刺栓塞后造影显示肿瘤血管染色明显减少,供血动脉远端未见明显显示。所有患者在栓塞后1周内行手术切除,术中出血明显减少,出血量150～500ml,平均350ml。结论直接穿刺肿瘤栓塞(DPTE)技术安全,能有效栓塞瘤腔,明显减少术中出血。Objective To discuss the clinical application of direct puncture tumor embolization,which is used as a preoperative supplementary embolization,in treating juvenile nasopharyngeal angiofibroma（JNA）.Methods Twenty-nine patients were enrolled in this study.The shape and location of JNA were documented through the carotid angiography.Then,an 18-gauge needle was used to puncture the tumor.After the needle＇s position was confirmed to be in the right site and it was certain that no contrast leaked into the brain,20-25% N-butyl-2-cyanoacrylate was slowly injected under fluoroscopic guidance until the entire JNA was fully filled with it.Results Angiography revealed that the JNA received its blood supply from both the internal carotid artery and the external carotid artery in all 29 patients.After direct puncture tumor embolization the tumor stain became lessened and the distal end of the supplying arteries was not obviously displayed.Surgical resection was carried out within one week after embolization and the blood loss during the surgery was significantly reduced to 150-500ml（mean 350ml）.Conclusion Percutaneous direct puncture tumor embolization is a safe treatment for juvenile nasopharyngeal angiofibroma,it can effectively occlude the tumor＇s vessels and markedly reduce the blood loss during the surgery.

关 键 词：鼻咽肿瘤 穿刺 栓塞 血管造影 

分 类 号：R739.63[医药卫生—肿瘤]