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目的:探讨鼻内镜下联合选择性动脉栓塞治疗鼻咽血管纤维瘤(NA)的可行性。方法:回顾性分析2003年12月至2010年9月诊治的7例NA患者的临床资料,其中3例Ⅰ期患者,2例Ⅱ期患者,2例Ⅲ期患者,术前均行选择性动脉栓塞,术中采用控制性低血压全身麻醉,在鼻内镜下完成肿瘤切除手术,带吸管电凝辅助止血。结果:7例患者肿瘤均彻底切除,手术平均时间(110±33.5)min,术中出血量介于230～650mL,中位数出血量380mL,所有患者术中、术后均未输血,均无并发症发生,术后随访6个月～6年,随访期间肿瘤无复发。结论:鼻内镜下联合选择性动脉栓塞治疗NA切除手术治疗Ⅰ期及Ⅱ期NA患者,具有出血量少、肿瘤切除彻底等优点,对局限于鼻腔、鼻咽腔、筛蝶窦及未侵犯颞下窝的外侧区和未侵犯颅内的Ⅲ期NA患者也适用。
Objective: To investigate the feasibility of endoscopic treatment of nasopharyngeal angiofibroma (NA) with selective arterial embolization. Methods: The clinical data of 7 NA patients diagnosed and treated from December 2003 to September 2010 were retrospectively analyzed. Among them, 3 patients with stage I, 2 patients with stage II, and 2 patients with stage III received selective arteries before operation. Embolization, controlled hypotension general anesthesia during operation, tumor resection under nasal endoscopy, electrocoagulation with a straw to assist in hemostasis. Results: All the 7 patients were completely resected. The average operation time was (110±33.5) minutes. The intraoperative blood loss was between 230 and 650 mL. The median blood loss was 380 mL. All patients had no blood transfusion during and after surgery. Complications occurred and were followed up for 6 months to 6 years. No tumor recurrence occurred during follow-up. Conclusions: Nasal endoscopic combined with selective arterial embolization for the treatment of stage I and stage II NA patients with less blood loss, thorough tumor resection, etc., is limited to the nasal cavity, nasopharyngeal cavity, ethmoid sinus and without violation The lateral area of the infratemporal fossa and patients with non-invasive intracranial phase III NA also apply.