局部穿刺栓塞治疗头颈部高血流病变  

Embolization of the high-flow vascular lesion in the head and neck by direct percutaneous puncture

作　　者：范新东[1] 张陈平[2] 王佩华[3] 石润杰[3] 

机构地区：[1]上海第二医科大学附属上海第九人民医院放射科,200011 [2]上海第二医科大学附属上海第九人民医院口腔颌面外科,200011 [3]上海第二医科大学附属上海第九人民医院耳鼻喉科,200011

出　　处：《中华放射学杂志》2003年第5期457-459,共3页Chinese Journal of Radiology

摘　　要：目的　总结局部穿刺栓塞治疗头颈部高血流病变的经验。方法　 11例头颈部高血流病变 ( 8例颌骨中心性血管瘤 ,3例鼻咽纤维血管瘤 )进行了局部穿刺栓塞治疗。数字减影颈动脉造影在PhilipsV30 0 0下完成。颌骨中心性血管瘤采用的栓塞材料为附纤毛的螺形圈 ,鼻咽纤维血管瘤采用的栓塞材料为组织胶 (N butyl 2 cyanoacrylate,NBCA)。穿刺针为 14G和长 7号注射针。结果颌骨中心性血管瘤急性出血的患者经局部穿刺栓塞圈栓塞 ,有效控制了出血。随访 9～ 2 4个月后 ,未发现有口腔内渗血或出血 ,随访X线平片可见螺形圈周围成骨。 3例鼻咽纤维血管瘤局部穿刺栓塞后行手术治疗 ,手术中未行输血 ,完整摘除肿瘤。结论　局部穿刺栓塞治疗头颈部高血流病变是 1种有效、安全的治疗方法。Objective To report our experience in the embolization of the high-flow vascular lesion in the head and neck by direct percutaneous puncture. Methods Eleven cases of high-flow vascular lesion in the head and neck (8 cases of central hemangioma of the jaws and 3 cases of juvenile nasopharyngeal angiofibroma) were included in this study group. The patients of central hemangioma of the jaws were embolized with coils by a 14-gauge needle, and the fibered coils were placed directly into the center of the intraosseous AVM. The patients of juvenile nasopharyngeal angiofibroma were embolized with NBCA by a No.7 needle. The procedure was under the guidance of DSA machine (Philips V3000). Results The acute arterial bleeding in patients with central hemangioma of the jaws from the extraction of the tooth was controllable, and the pericoronal oozing of bleed disappeared in the 9-24 months follow-up. The juvenile nasopharyngeal angiofibromas were resected without blood transfusion after the embolization. Conclusion The embolization of the high-flow vascular lesion in the head and neck by direct percutaneous puncture was effective and safe, however the longer follow-up was expected.

关 键 词：头颈部高血流病变 局部穿刺栓塞治疗 数字减影血管造影 颌骨中心性血管瘤 鼻咽纤维血管瘤 

分 类 号：R730.5[医药卫生—肿瘤]