动脉栓塞联合手术治疗丛状神经纤维瘤研究  

Study on treatment of plexus neurofibroma by arterial embolization combined with surgery

作　　者：葛玉瑶 蒋邦红 钱景瑜[2] 张雷鸣 逯瑶 石傲 张莉[1] GE Yuyao;JIANG Banghong;QIAN Jingyu;ZHANG Leiming;LU Yao;SHI Ao;ZHANG Li(Department of Plastic Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233000,China;Department of Interventional Radiology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠医学院第一附属医院整形外科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院介入科,安徽蚌埠233000

出　　处：《重庆医学》2023年第11期1665-1670,共6页Chongqing medicine

基　　金：安徽省高校自然科学研究重点项目(KJ2021A0804);蚌埠医学院2021年度研究生科研创新计划(Byycxz21089)。

摘　　要：目的探讨超选择性动脉栓塞联合手术切除治疗巨大丛状神经纤维瘤的疗效与应用。方法选择2013年6月至2021年9月该院整形外科收治的18例巨大丛状神经纤维瘤患者为研究对象。其中,8例进行超选择性动脉栓塞联合手术切除治疗(动脉栓塞组),10例采用缝线环扎、电凝、肿胀麻醉等常规止血治疗(常规治疗组)。从围术期出血量、输血量、手术时间、并发症、术后生存质量等各个方面对两种治疗方案进行对比分析。结果两组患者在围术期出血量、手术时间、输血量等方面比较差异有统计学意义(P<0.05),动脉栓塞组的术后并发症发生率明显低于常规治疗组(12.50%vs.70.00%,χ^(2)=5.951,P=0.025)。18例患者均进行6个月以上的随访,除1例复发外,其余患者恢复良好。采用Peds QL神经纤维瘤病1型(NF-1)模块量表评估患者术后生存质量,动脉栓塞组患者生存质量明显高于常规治疗组患者[(88.95±3.24)分vs.(80.65±3.92)分,t=4.810,P<0.001]。结论超选择性动脉栓塞能够明显减少围术期出血量、减少输血量、缩短手术时间,降低并发症发生率、提高术后生存质量,联合手术切除治疗应用于巨大丛状神经纤维瘤治疗安全有效。Objective To investigate the efficacy and application of super-selective arterial embolization combined with surgical resection in the treatment of giant plexus neurofibroma.Methods From June 2013 to September 2021,a total of 18 patients with giant plexus neurofibroma were choose as the study object,of which 8 cases were treated by super-selective arterial embolization combined with surgical resection(the arterial embolization group),and 10 cases underwent traditional hemostatic methods,such as suture,electrocoagulation,and tumescent anesthesia(the conventional treatment group).The two therapeutic regimens were compared and analyzed from the aspects of perioperative bleeding volume,blood transfusion,operation time,postoperative complications,and status of postoperative quality of life.Results Significant differences were found in perioperative bleedingvolume,operation time,blood transfusion between the arterial embolization group and the conventional treatment group(P<0.05).The incidence of postoperative complications was lower in the arterial embolization group than in the conventional treatment group(12.50%vs.70.00%,χ^(2)=5.951,P=0.025).All patients were postoperatively monitored for at least 6 months,and all patients recovered well except one was found to have a recurrence.Using Peds QL neurofibromatosis type 1(NF1)module scale to assess patients postoperative quality of life,the quality of life in the arterial embolization group was apparently higher than that in the conventional treatment group[(88.95±3.24)vs.(80.65±3.92),t=4.810,P<0.001].Conclusion The super-selective arterial embolization can significantly reduce perioperative bleeding volume,reduce blood transfusion,shorten the operation time,reduce the incidence of complications,and improve the quality of life.Combined with surgical treatment for giant plexus neurofibroma,super-selective arterial embolization is safe and effective.

关 键 词：动脉栓塞 巨大神经纤维瘤 介入治疗 神经纤维瘤1型 丛状神经纤维瘤 

分 类 号：R739.4[医药卫生—肿瘤]