CAJ | 학술논문

目的探索经鼻内窥镜切除鼻咽纤维瘤的手术方法.方法对11例鼻咽纤维瘤患者,经鼻内窥镜手术切除,chandler分期:Ⅱ期5例,Ⅲ期5例,Ⅳ期1例.结果 11例患者手术时间为1.5～5.5h,术中出血量150～2100 ml,没有术中及围手术期并发症的发生.2例联合柯—陆氏入路手术,1例鼻侧切开入路手术.72 h后分次取出前鼻孔填塞物.术后随访6 ～38个月,平均16个月,均未发现肿物残留及复发,术腔上皮化良好,周围结构无解剖异常及功能障碍.结论鼻内窥镜或鼻内窥镜为主的鼻咽纤维血管瘤切除术可作为该肿瘤切除的首选方法,3期双重供血的鼻咽纤维血管瘤鼻内镜手术切除是可行的,术前栓塞、术中控制性降压、合理的手术策略是手术成功的保证.
목적 탐색경비내규경절제비인섬유류적수술방법.방법 대11례비인섬유류환자,경비내규경수술절제,chandler분기:Ⅱ기5례,Ⅲ기5례,Ⅳ기1례.결과 11례환자수술시간위1.5～5.5h,술중출혈량150～2100 ml,몰유술중급위수술기병발증적발생.2례연합가—륙씨입로수술,1례비측절개입로수술.72 h후분차취출전비공전새물.술후수방6 ～38개월,평균16개월,균미발현종물잔류급복발,술강상피화량호,주위결구무해부이상급공능장애.결론 비내규경혹비내규경위주적비인섬유혈관류절제술가작위해종류절제적수선방법,3기쌍중공혈적비인섬유혈관류비내경수술절제시가행적,술전전새、술중공제성강압、합리적수술책략시수술성공적보증.
Objective To investigate the surgical methods of endoscopic resection of juvenile nasopharyngeal angiofibroma(JNA).Methods The clinical data of 11 patients diagnosed with juvenile nasopharyngeal angiofibroma form Jnly 2006 to Jnly 2013 were analyzed,aged from 14-27 years,5 cases of stage Ⅱ,5 cases of stage Ⅲ,1 case of stage Ⅳ.Results The operative time was from 1 h 30 m ～ 5 h 30 m,the blood loss was 150-2100 ml.There was no intraoperative and perioperative complications.Postoperative follow-up period was 6 months to 36 months (mean 16 months),no recurrence or residual tumor were found,operative cavities were well epithelized,the surrounding structure without any anatomical abnormalities or dysfunction.Conclusions Nasal endoscopy or endoscopy mainly resection of JNA can be used as the best preferred method,endoscopic surgery for JNA of stage Ⅲ with dual blood supply is feasible; preoperative embolization,intraoperative controlled hypotension,and reasonable surgical strategy are to ensure the success of the operation.