急症血管内栓塞治疗外伤性颈内动脉海绵窦瘘  

Emergency treatment by intravascular embolizatfon in traumatic carotid cavernous fistula

作　　者：唐军[1] 刘延军 李丰新 孙增涛[1] 刘作勤[1] 

机构地区：[1]山东省医学影像学研究所介入科,济南250021 [2]山东省陵县人民医院放射科

出　　处：《中华放射学杂志》2006年第9期966-969,共4页Chinese Journal of Radiology

摘　　要：目的探讨血管内栓塞治疗外伤性颈内动脉海绵窦瘘(TCCF)在紧急情况下的应用价值。方法 TCCF 297例,急诊血管内栓塞治疗36例中,其中严重鼻出血22例,大量流入皮质静脉9例,颅内出血3例,视力恶化3例,肢体功能障碍2例。全部病例采用可脱性球囊栓塞瘘口或闭塞颈内动脉,5例患者用可脱性球囊闭塞瘘口及颈内动脉后,采用弹簧圈保护性闭塞颈内动脉。结果 36例中,1次性栓塞瘘口并颈内动脉通畅19例;1次性栓塞瘘口部及颈内动脉者17例。22例鼻出血者未再出血;3例颅内出血未再发生出血;3例视力恶化者2例视力恢复,1例明显提高;2例肢体功能障碍明显改善。结论血管内栓塞治疗 TCCF 是首选的治疗方法,急诊栓塞治疗对一些危及生命或可能导致严重后遗症的 TCCF 是必要、安全和有效的。Objective To discuss the method of interventional intravascular treatment in traumatic carotid cavernous fistula （TCCF） and the significance of clinical application in emergency. Methods In 297 cases of TCCF, 36 cases were treated by interventional intravascular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery. In the 36 cases, serious epistaxis occurred in 22 cases, cortical vein inflow in 9 cases, intracranial hemorrhage in 3 cases, aggravation of eyesight in 3 cases, and limb dysfunction in 2 cases. Results Fistula was successfully embolized and internal carotid artery remained patent in 19 cases. Complete embolization of orificium or internal carotid artery was achieved in 17 cases. The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped. Eyesight recovered in 2 cases and improved in 1 case. Limb dysfunction improved evidently in 2 cases. Conclusion Intravascular embolization treatment is the first therapeutic choice for TCCF, especially in emergency. It is necessary, safe and effective.

关 键 词：颈内动脉海绵窦瘘 外伤 栓塞 治疗性 急诊处理 

分 类 号：R651.1[医药卫生—外科学]