鼻内镜辅助超声刀鼻咽血管纤维瘤切除手术.pdfVIP

l86 Chin Otorhino1arvngo1 J Intee Med 2008．Vo1．1 6．NO．3 鼻内镜辅助超声刀鼻咽血管纤维瘤切除手术 李楚凌 粱华珍 吴陆敬 袁先平 【摘要】目的 探讨从鼻腔径路鼻咽血管纤维瘤超声刀切除术减少术中出血的可行性 方法 14例鼻咽血管纤维瘤患者， 行同侧主供血动脉DSA栓塞后经传统硬腭径路手术7例，鼻内镜下辅以鼻腔径路超声刀手术7例，比较两组患者的出血量、手术 时间等指标。结果 传统手术术中出血约700 1200ml，平均860ml，手术时间180-300rain；鼻内镜下辅以鼻腔径路超声刀手术 术中出血约250~350ml，平均293ml，手术时间90-180min，组间差异有统计学意义(均P0．001)。结论 鼻内镜下辅以腔径路 超声刀手术，是有效切除鼻咽血管纤维瘤的安全术式，能明显减少术中出血，缩短手术时间，降低术后复发率。 【关键词】鼻咽血管纤维瘤；超声刀；鼻内镜；外科手术 Nasal endoscopic surgery assisted with Ultracision—Harmonic Scalpel for excision of nasopharyngeal angiofibroma LI Chuling．LING／／uazhon．WU Lugfng, YUAN Xianping ／?opt of Otolaryngology-Head Neck Surgery,ttuangjfang ttospitaL 6uangdong,523750, ina [Abstractl 0bjective To explore the feasibility ofnasal endoscopic surgery assisted Wit11 Ultracision-Harmonic Scalpel for excision ofnasopharyngeal angiofibroma based on a clinical tria1．Methods Included in this trial were 14 cases wit11 nasopharyngeal angiofibroma． wit11 7 treated via claasic hard palate approach following ipsilateral arterial embolization under DSA while the other 7 treated via nasal approach under endoscope assisted by Ultracision—Harmonic Scalpe1．Then，a comparative analysis was carried out between the two groups to see the differences in the bleeding volume and operative duration during the operation．Results For the classic surgical approach，the averaged bleeding volum e Was about 860 ml(700~1 200 m1)and the operating duration was lasted about 3-5 hours，while t11ey were 293 ml 50~350 m1)and 1．5—3 hours respectively,with very significam differences among these data(P0．OO1)for the nasal approach under endoscope assisted with Ultracision—Harmonic Scalpe1．Conclusions The surgical procedure via nasal cavity under endoscope assisted by Ultracision—Harmonic Scalpel is effective and safe for nasopharyngeal angiofibr