鼻咽癌放疗后大出血的诊治  

Management of massive epistaxis after radiotherapy of nasopharyngeal carcinoma

作　　者：陈净华[1] 娄光明[1] 黄宇勇[1] 

机构地区：[1]福建医科大学附属龙岩第一医院耳鼻咽喉科,福建龙岩364000

出　　处：《中国耳鼻咽喉颅底外科杂志》2017年第4期359-362,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨鼻咽癌放疗后大出血的诊治方法及治疗结果。方法收集2011年1月~2015年12月诊治的7例鼻咽癌放疗后大出血患者,分析其临床特点、各种诊治方法的特点及疗效。结果 7例鼻咽癌放疗后大出血患者,治愈出院2例,转院行颈内动脉栓塞1例,已治愈。住院期间死亡3例,1例自动出院后死亡。结论鼻咽癌放疗后大出血积极的检查明确出血原因及部位,针对出血原因及部位可采取治疗措施,包括预防性气管切开,不得已情况下的长时间填塞及颈内动脉栓塞,能够有效降低鼻咽癌放疗后鼻出血的死亡率。Objective To study the clinical management of massive epistaxis after radiotherapy of nasopharyngeal carcinoma （NPC） and evaluate the therapeutic outcome. Methods Clinical data of 7 NPC patients with massive epistaxis after radiotherapy admitted to our department from Jan 2011 to Dee 2015 were analyzed retrospectively. The clinical characteristics of the massive epistaxis, the features and effects of its various management methods were summarized. Results Of all the 7 cases, 2 were cured in our department, one was transferred and cured with embolization of internal carotid artery, 3 cases died during in-hospital period, and one died after voluntary discharge. Conclusions For massive epistaxis after radiotherapy of NPC, aggressive investigations should be performed to determine the cause and site, and to adopt proper management strategy. Treatments including preventive tracheotomy, long-term nasal packing and embolization of internal carotid artery by some unavoidable circumstances can effectively decrease the mortality of massive epistaxis after radiotherapy of NPC.

关 键 词：鼻出血 鼻咽癌 放疗 

分 类 号：R739.63[医药卫生—肿瘤]