目的:探讨鼻咽纤维血管瘤术前栓塞的应用价值。方法:17例鼻咽纤维血管瘤患者,单纯手术摘除10例,术前3天进行数字减影血管造影(DSA)检查及血管内栓塞术7例。结果:7例术前栓塞组术中出血200～700mL,平均430mL;输血0～550mL;10例单纯手术组出血550～1430mL,平均1200mL,输血350～1200mL。术前栓塞组出血量和输血量较单纯手术组显著减少。结论:术前瘤体栓塞治疗鼻咽纤维血管瘤是安全有效、理想的术前辅助治疗手段。
Giant cavernous hemangioma of max-illofacial region and central hemangioma ofthe mandible were a rare,benign conditionthat was characterized by the proliferationof blood vessels. Surgical treatment has beenadvocated by many authors, although thedanger of bleeding must be taken into consid-eration in every cases. This article reported11 successful cases. Management of these cas-es may be accomplished by open- ligationof inferior alveolar vessels and repaired withfree forearm flap (7 cases). The results weres satisfactory.
ObjectiveTo explore the clinical efficacy of transcatheter arterial embolization or transcatheter arterial embolization combined with percutaneous transhepatic sclerotherapy injection for hepatic cavernous hemangioma with different blood supply. MethodsEighty-six patients with hepatic cavernous hemangioma with different blood supply received femoral artery pingyangmycin iodized oil embolization or transcatheter arterial embolization combined with percutaneous transhepatic injection of pingyangmycin iodized oil embolization from February 2004 to April 2013. ResultsForty-five cases (52.3%) of tumor decreased by over 50%; 26 (30.2%) decreased by about 20% to 50%; 11 (12.8%) decreased by less than 20%; and 4 (4.7%) had no significant change in the tumor diameter. Patients did not have serious complications. ConclusionThe effect of individualized intervention for hepatic cavernous hemangioma with different blood supply is obvious, and it is a safe and effective therapeutic method.
目的总结肝尾状叶海绵状血管瘤手术切除的指征及技巧。方法对我科2005年9月至2010年9月期间开展的8例肝尾状叶海绵状血管瘤切除病例的临床资料进行分析。结果全组患者均在无血流阻断下顺利完成手术，无手术死亡。术中出血量为1 000～5 000 ml，（2 500±800） ml; 手术时间为3～6 h，(4.2±0.8） h。1例肝硬变患者术后1 d即出现腹水，经积极治疗后得以控制。3例患者术后1周发现右侧胸腔积液，经1～2次胸腔穿刺抽液后治愈。1例患者术后1周出现不全性肠梗阻，经保守治疗1周后痊愈。术后应用B超每半年复查肝脏情况，随访0.5～5年，（2.5±1.2）年，1例失访，1例患者死于心肌梗死，余均存活，仍在随访中。所有病例均未复发。结论肝尾状叶海绵状血管瘤手术应充分显露、精准操作，彻底切除肿瘤，避免大出血和空气栓塞，减少和防止残肝的热缺血再灌注损伤。