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目的:探讨经导管超选择性动脉栓塞术在鼻咽纤维血管瘤切除术前治疗的临床价值。方法:12例经CT和MRI诊断,术前全部行双侧颈内外动脉及椎动脉DSA血管造影,并行导管明胶海绵1mm×1mm×1mm颗粒栓塞肿瘤供血动脉(主要为颈外动脉的颌内动脉和(或)咽升动脉)后再手术的结果。栓塞后1~4 d内行手术切除。结果:所有患者颈外动脉供血分支4F导管超选择性栓塞均获得成功。栓塞后,9例肿瘤染色完全消失,3例肿瘤染色大部分消失。12例在选择性颈外动脉栓塞后行手术治疗术中出血量明显减少,本组栓塞后1~4天手术。手术全切率92%(12/12),手术平均出血约350ml。未见严重并发症。结论:使用4F导管术前血管内超选择栓塞鼻咽部纤维血管瘤,是一种安全有效的辅助治疗方法。
Objective: To investigate the clinical value of transcatheter super selective arterial embolization in the treatment of nasopharyngeal fibrovascular tumors. Methods: Twelve cases were diagnosed by CT and MRI. DSA angiography of bilateral internal and external carotid arteries and vertebral arteries were performed before operation. Allograft catheters of 1mm × 1mm × 1mm catheters were implanted with gelatin sponge (mainly the internal carotid artery And / or pharyngeal ascending aorta) and then surgery results. Surgical resection was performed within 1 ~ 4 days after embolization. Results: Superselective embolization of the 4F catheter in the external carotid artery in all patients was successful. Embolization, 9 cases of tumor staining completely disappeared, most of the 3 cases of tumor staining disappeared. 12 cases of surgical treatment of selective external carotid artery embolization was significantly reduced bleeding, the group after embolization 1 to 4 days surgery. Surgical total cut rate of 92% (12/12), the average surgical bleeding about 350ml. No serious complications. Conclusion: 4F catheter preoperative intravascular ultrasound catheter embolization nasopharyngeal fibrovascular tumor, is a safe and effective adjuvant therapy.