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目的探讨颌面部血管瘤动脉栓塞的适应证、栓塞剂选择、造影栓塞方法的运用及并发症的预防。材料和方法回顾性分析２０例颌面部血管瘤，对１６例行１７次颈外动脉及其分支栓塞，１４例为术前栓塞，２例为根治性栓塞。根治性栓塞和２例颌骨中心性血管瘤用无水乙醇加明胶海绵栓塞，余均用明胶海绵栓塞。结果根治性栓塞的２例，观察９～１２月未复发，术前栓塞的１４例，术中出血量和输血量比术前未栓塞的４例减少７５％和７０％。结论①颌面部血管瘤行动脉栓塞的适应证为：颌骨中心性血管瘤，蔓状血管瘤；供血动脉明确造影时瘤腔显影的海绵状血管瘤。以下情况不宜栓塞：颈动脉分叉处血管瘤；颈内外动脉有异常交通者；供血动脉不明确的海绵状血管瘤以及特敏患者。②用明胶海绵作术前辅助性栓塞，用无水乙醇加明胶海绵永久性栓塞效果好。③作颌内动脉栓塞时导管应插至发出脑膜中动脉以远，否则，观察脉络膜动脉不显影，向靶动脉注入利多卡因无不良反应才可栓塞，栓塞剂颗粒直径以０．５ｍｍ以下为宜
Objective To investigate the indications of arterial embolization in maxillofacial hemangiomas, selection of embolization agents, use of contrast embolization methods and prevention of complications. Materials and Methods Retrospective analysis of 20 cases of maxillofacial hemangiomas, 16 cases of external carotid artery and its branches embolized 17 cases, 14 cases of preoperative embolization, and 2 cases of radical embolism. Radical embolization and 2 cases of central hemangioma of the jaws were embolized with gelatin and gelatin sponge. The rest were embolized with Gelfoam. RESULTS: Two cases of radical embolization were observed. No recurrence was observed from September to December. Fourteen patients had preoperative embolization. The amount of intraoperative blood loss and blood transfusion were reduced by 75% and 70% compared with 4 cases without preoperative embolization. Conclusion 1 The indications for arterial embolization in maxillofacial hemangiomas are: central hemangioma of the jaws, hemangioma, and cavernous hemangioma with clear imaging of the blood supply artery. Embolization is not suitable in the following cases: hemangiomas in the carotid bifurcation; abnormal traffic in the internal and external carotid arteries; cavernous hemangiomas in which the supplying arteries are unclear and particularly sensitive patients. 2 Gelatin sponge was used for preoperative adjuvant embolization, and the effect of permanent embolization with absolute ethanol and gelatin sponge was good. 3 When the internal maxillary artery is embolized, the catheter should be inserted farther than the middle meningeal artery. Otherwise, the choroidal artery is not visualized. Lidocaine can be injected into the target artery without any adverse reactions before embolization. The diameter of the embolic agent is 0.5 mm or less. should