严重外伤性鼻出血介入栓塞治疗体会  

Interventional Treatment of Obstinate Traumatic Epistaxis

作　　者：解岗[1] 陈怀瑞[2] 白如林[2] 

机构地区：[1]蚌埠医学院第三附属医院神经外科,安徽省宿州市234011 [2]上海长征医院神经外科,200003

出　　处：《中华全科医学》2010年第8期975-976,共2页Chinese Journal of General Practice

摘　　要：目的分析急诊介入栓塞法在控制外伤所致的鼻腔大出血的临床治疗价值。方法 10例外伤所致的鼻腔大出血者,在DSA明确出血靶动脉后用栓塞材料(聚乙烯醇颗粒、明胶海绵、球囊、弹簧圈)行急诊出血靶动脉栓塞术。结果 10例患者中单纯颌内动脉损伤者5例,面动脉分支供血1例,颈内外动脉交通(翼管动脉)1例,颈内动脉海绵窦瘘1例,颈内动脉假性动脉瘤1例,颈内动脉海绵窦瘘合并颈内动脉假性动脉瘤1例。成功行损伤靶动脉栓塞术10例。栓塞术后鼻口腔活动性出血在4h内均停止。10例患者在栓塞24h后生命体征均趋平稳,所有患者均经康复治疗后顺利出院。结论栓塞术可在微创的情况下解决外伤性严重鼻出血。Objective To investigate the effect of the interventional embolization under emergence in the treatment of obstinate traumatic epistaxis.Methods 10 cases of obstinate traumatic epistaxis were treated with interventional embolization material[polyvinyl alcohol particles（PVA）,Gelfoam particle,detachable balloons and microcoils],after cerebral angiogram,the bleeding point and target vessel were confirmed.Results Of the 10 cases,the epistaxis was csused by injury of internal maxillary artery in five cases,branch of facial artery in one case,artery of pterygoid canal in one case,carotid cavernous fistula in one case,internal carotid artery pseudoaneurysm in one case and carotid cavernous fistula combine with sphenoid sinus pseudoaneurysm in one case.The procedure was accomplished in one manipulation in all cases.Haemostasis was achieved in all cases,without procedure related complication.Conclusion Transcatheter arterial embolization was a safe and effective minimal invasional therapy for obstinate traumatic epistaxis.

关 键 词：鼻出血 栓塞 颈动脉 

分 类 号：R765.8[医药卫生—耳鼻咽喉科]