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目的 :探讨鼻咽血管纤维瘤的诊断和治疗。方法 :对 4 1例鼻咽血管纤维瘤采用不同进路进行手术治疗 ,其中腭进路 31例 ,面中部掀翻梨状孔进路 7例 ,扩大翼上颌裂进路 3例。结果 :术中平均出血量为 14 5 0ml,选择性瘤体供血动脉栓塞者出血量为 5 0 0～ 80 0ml。术后 1次复发 5例 ,2次复发 3例 ,术后复发时间为 0 .5～2年。结论 :术前应根据CT检查的结果认真制定手术进路 ;术前行血管造影及选择性血管栓塞 ,可明显减少术中出血量。此外 ,根据肿瘤的生长部位 ,在考虑面部美容效果的同时 ,术中应充分暴露术野 ,争取一次切除肿瘤
Objective: To investigate the diagnosis and treatment of nasopharyngeal angiofibroma. Methods: 41 cases of nasopharyngeal angiofibroma were treated by different approaches. Among them, there were 31 cases of palatal approach, 7 cases of piriform hole approach in central part, and 3 cases of maxillary fissure approach. Results: The average blood loss during operation was 145.0ml, and the blood loss of the selective aneurysm embolization was between 500 and 80ml. After recurrence in 5 cases, 2 cases of recurrence in 3 cases, the recurrence time was 0.5 to 2 years. Conclusion: Preoperative surgical approach should be carefully established based on the results of CT examination. Preoperative angiography and selective embolization can significantly reduce intraoperative blood loss. In addition, according to the site of tumor growth, cosmetic effects in the face to consider at the same time, surgery should be fully exposed surgical field for a removal of the tumor