鼻咽纤维血管瘤减少术中出血方法的比较(附56例报告)  

Comparing the methods of reducing bleeding in juvenile nasopharyngeal angiofibroma operation:with a report of 56 cases

作　　者：乔明哲[1] 徐洁洁[1] 乔宗海[1] 卜行宽[1] 

机构地区：[1]南京医科大学第一附属医院耳鼻喉科,江苏南京210029

出　　处：《山东大学基础医学院学报》2003年第6期338-339,共2页Journal of Preclinical Medicine College of Shandong Medical University

摘　　要：目的 :探讨减少鼻咽纤维血管瘤术中出血量 ,防止出血的有效方法。方法 :回顾分析手术治疗鼻咽纤维血管瘤 5 6例的临床资料 ,按时间及减少出血方法的演变分为冷冻组 ,颈外动脉结扎组 (结扎组 ) ,动脉造影栓塞组 (栓塞组 ) ,低温麻醉控制性低血压组 (低温组 ) ,未采用任何措施组 (空白组 ) ,比较各种方法的疗效。结果 :几种方法各有优缺点。平均出血量分别为 :冷冻组 6 90ml,结扎组 6 70ml ,栓塞组 190 0ml ,低温组 86 0ml,空白组 6 5 0ml。结论 :低温麻醉控制性低血压优点明显 ,可作为首选方法 ,对瘤体巨大 。Objective:To evaluate the effects of different methods of reducing bleeding in juvenile nasopharyngeal angiofibroma operation .Method: 56 patients were divided into five groups: (1) cryotherapy; (2) ligation of external carotid artery; (3) arteriography and embolization; (4) hypotension with hypothermal anesthesia; (5) controls.Result: Each method had strong and weak points.Average bleeding volume was 690ml in cryotherapy , 670ml in ligation ,1900ml in embolization ,860ml in hypotension and 650ml in control respectively. Conclusion: Hypotension with hypothermal anesthesia has the evident advantage over other groups and can be considered as a first choice of reducing bleeding. The combination of embolization and hypotension may be applied to the cases with gigantic tumor ,extensive invasive or recurrent tumor.

关 键 词：鼻咽肿瘤 血管纤维瘤 术中出血 动脉造影栓塞 低温麻醉控制性低血压 颈外动脉结扎 

分 类 号：R739.63[医药卫生—肿瘤] R730.56[医药卫生—临床医学]