外伤性蝶窦内颈内动脉假性动脉瘤的诊断及治疗探讨(附6例报告)  

The diagnosis and treatment of traumatic pseudoaneurysm of internal carotid artery in sphenoid sinus(a report of 6 cases)

作　　者：乐建新[1] 孔维佳[1] 杨成章[1] 张松[1] 王彦君[1] 陈雄[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻咽喉科,武汉430022

出　　处：《临床耳鼻咽喉头颈外科杂志》2009年第18期843-845,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨外伤性蝶窦内颈内动脉假性动脉瘤的早期诊断方法,防止误诊,并选择正确的治疗方法,降低死亡率。方法:回顾性分析6例确诊为外伤性蝶窦内假性动脉瘤患者的诊断和治疗经过,并结合国内外相关文献资料,提出早期诊断方法,选择最佳治疗方案。结果:6例患者均有头部外伤病史,并有不同程度反复发作的鼻出血,2例单眼失明;6例中1例行一侧颈总动脉结扎,3例行可脱球囊闭塞动脉瘤及颈内动脉,1例行微弹簧圈栓塞颈内动脉,该5例均痊愈;1例仅反复行鼻腔填塞,因大出血死亡。结论:该病可因难已控制的鼻出血而致死,早期诊断,合理治疗可治愈。Objective：In order to prevent misdiagnosis and degrade death rate, we explored the early diagnosis and correct treatment methods of traumatic pseudoaneurysm of internal carotid artery in sphenoid sinus,. Method： The clinic data of 6 cases who had traumatic pseudoaneurysm of internal carotid artery in sphenoid sinus and were admited in our hospital were analyzed retrospectively. Large numbers of literature about the disease were reviewed. Some early diagnosis methods and optimal treatment schemes were proposed. Result： All patients had a history of cranium trauma and recurrent attacks nasal hemorrhage. There are two patients with a complication of sight loss in single eye. In the six cases, one case was treated with unilateral common carotid artery ligation, three cases were treated with aneurysm and internal carotid artery embolism by using saeculus proprius which is able to shedding , one case was treated with internal carotid artery embolism by using tiny circlip ring . These five pa- tients were crued with no severe complication. One patient death of hemorrhea. His nasal cavity was tamponaded repeatly because repeat nasal hemorrhage. However, he had never treated with internal carotid artery embolism. Conclusion：The patients who have traumatic pseudoaneurysm of internal carotid artery usually die of unmanageable hemorrhea. The patients may be cured if they could obtain an early diagnosis and correct treatment.

关 键 词：蝶窦 颈内动脉 假性动脉瘤 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]