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目的探讨数字减影血管造影(DSA)及栓塞在鼻咽部血管纤维瘤诊断和治疗中的价值。方法对16例鼻咽部血管纤维瘤进行DSA检查和选择性栓塞肿瘤供血动脉。栓塞后2～7天行鼻内镜下肿瘤切除。结果DSA检查使鼻咽血管纤维瘤获得明确的诊断,所有病例均主要由同侧的颌内动脉供血,咽升动脉参与供血1例,同侧颈内动脉参与供血1例,16例患者均栓塞成功。鼻内镜下肿瘤全切除者15例,大部分切除者1例,术中出血明显减少,术中及术后无严重并发症。结论鼻咽血管纤维瘤的数字减影血管造影能显示病变的范围、血供情况及其特征。栓塞有助于减少术中出血,提高手术安全性及全切率,为内镜下手术的必备条件。
Objective To investigate the value of digital subtraction angiography (DSA) and embolization in the diagnosis and treatment of nasopharyngeal angiofibroma. Methods 16 cases of nasopharyngeal angiofibroma DSA examination and selective embolization of tumor feeding artery. 2 to 7 days after embolization under endoscopic resection of the tumor. Results DSA examination confirmed the diagnosis of nasopharyngeal angiofibroma. All patients were mainly supplied with ipsilateral maxillary artery, pharyngeal ascending artery in 1 case, ipsilateral internal carotid artery in 1 case, and 16 cases in all success. Endoscopic resection of the tumor in 15 cases, most of the resection in 1 case, significantly reduced bleeding during and after surgery and no serious complications. Conclusion Digital subtraction angiography of nasopharyngeal angiofibroma can show the extent of disease, blood supply and its characteristics. Embolization helps to reduce intraoperative bleeding, improve surgical safety and cut rate, which is a prerequisite for endoscopic surgery.