Analysis of the effectiveness of preoperative modified internal carotid artery embolization in recurrent nasopharyngeal carcinoma
陈经 1林生 1林敏1
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作者信息
1. 福建中医药大学附属第二人民医院脑病科,福州 350003
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摘要
目的 探讨复发性鼻咽癌手术治疗前行改良颈内动脉栓塞术的有效性和安全性.方法 本研究为回顾性研究.搜集2022年6月—2023年8月于福建中医药大学附属第二人民医院接受改良颈内动脉栓塞术治疗的13例复发性鼻咽癌患者的病例资料.记录围手术期并发症,对比患者术前和术后30 d MRS评分,评估改良颈内动脉栓塞术的有效性和安全性.结果 13例患者球囊封堵试验均为阴性,且都顺利完成改良颈内动脉栓塞术,完全闭塞颈内动脉.手术时长50.0～110.0 min,平均(63.7±15.3)min;均未出现弹簧圈逃逸.1例术后发生语言不清、肢体无力,给予升压等对症治疗症状消失;1例术后发生头痛、复视,出院前已恢复;1例由于对侧颈内动脉狭窄同期支架植入,术后植入支架侧出现高灌注脑出血表现,术后30 d MRS评分4分.其余患者均未发生围术期并发症,术后30 d MRS评分均为0分.结论 针对复发性鼻咽癌侵犯颈内动脉的患者行改良颈内动脉栓塞术,可安全有效闭塞颈内动脉,降低后续鼻咽癌内镜手术中颈动脉出血发生率,提高患者生存预后.
Abstract
Objective To investigate the effectiveness and safety of preoperative modified internal carotid artery embolization in the treatment of recurrent nasopharyngeal carcinoma.Methods Clinical data of 13 patients with recurrent nasopharyngeal carcinoma who underwent modified internal carotid artery embolization from June 2022 to August 2023 at the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine were collected.Perioperative complications were recorded,and the preoperative and postoperative 30 d MRS scores were compared to evaluate the effectiveness and safety of modified internal carotid artery embolization.Results Balloon occlusion tests were negative in all 13 patients,and modified internal carotid artery embolization was successfully performed in all patients,achieving complete occlusion of the internal carotid artery.The duration of surgery ranged from 50.0 to 110.0 minutes,with an average of(63.7±15.3)minutes;no spring coil escape occurred.One patient experienced unclear speech and limb weakness postoperatively,which resolved with symptomatic treatment including blood pressure elevation;another patient experienced headache and diplopia postoperatively but recovered before discharge;one patient had a high perfusion cerebral hemorrhage manifestation on the side of stent placement due to concurrent stenting of the contralateral internal carotid artery,with an postoperative 30 d MRS score of 4.No perioperative complications occurred in the remaining patients,and their postoperative 30 d MRS scores were all 0.Conclusion For patients with recurrent nasopharyngeal carcinoma invading the internal carotid artery,preoperative modified internal carotid artery embolization can safely and effectively occlude the internal carotid artery,reducing the incidence of neck artery bleeding during subsequent nasopharyngeal carcinoma endoscopic surgery and improving patient survival prognosis.
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