目的 探讨鼻内镜下低温等离子射频切除术治疗鼻咽血管纤维瘤(nasopharyngeal angiofibroma,NA)的可行性.方法 回顾性分析2005年12月至2009年8月诊治的4例NA患者的临床资料,其中1例为Ⅰ期患者,3例为Ⅱ期患者,4例患者术前均行选择性动脉栓塞,采用控制性低血压全身麻醉,在鼻内镜下采用低温等离子射频刀完成肿瘤切除手术,双极电凝辅助止血.结果 4例患者肿瘤均彻底切除,手术时间分别为60、80、110、90 min,术中出血量分别为250、250、320、280 ml,所有患者术中、术后均未输血.术后随访6个月至4年,无并发症发生,肿瘤无复发.结论 鼻内镜下低温等离子射频切除手术治疗Ⅰ期及Ⅱ期NA患者,具有出血量少、肿瘤切除彻底等优点,是一种微创的手术治疗方法.%Objective To evaluate the feasibility of endoscopic surgery using the low-temperature plasma radiofrequency for nasopharyngeal angiofibroma (NA). Methods The clinical data of 4 patients treated between December 2005 and August 2009 were retrospectively analyzed. The tumor in one patient was at stage Ⅰ and three patients were at stage Ⅱ, all these patients were treated by endoscopic surgery using the low-temperature plasma radiofrequency under controlled hypotension anesthesia. Preoperative angiography and embolisation were underwent in all patients. Bipolar coagulation was used to help hemostasis during operation. Results The tumor in all 4 patients was completely removed. The operation time was 60,80, 110, 90 min respectively. The blood loss was 250, 250, 320, 280 ml respectively. Neither blood transfusion nor complications were encountered perioperatively. Follow-up ranged from 6 months to 4 years,none of the patients recurred. Conclusions Endoscopic surgery using low-temperature plasma radiofrequency for nasopharyngeal angiofibroma has many advantages such as less bleeding and total tumor removal. It is a minimally invasive surgical method for nasopharyngeal angiofibroma.
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