明胶海绵联合微弹簧圈栓塞治疗颅底骨折伴致命性鼻出血的疗效  

Efficacy of gelatin sponge combined with microcoil embolization in the treatment of skull base fracture with fatal epistaxis

作　　者：彭俏菁[1] 程巍[1] 黎源[1] 李秀云[2] 王志强[1] 李嘉豪 Peng Qiaojing;Cheng Wei;Li Yuan;Li Xiuyun;Wang Zhiqiang;Li Jiahao(Department of Neurology,Humen Hospital,Dongguan 523900,Guangdong China;Department of Nephrology,Humen Hospital,Dongguan 523900,Guangdong China)

机构地区：[1]东莞市虎门医院脑科,广东东莞523900 [2]东莞市虎门医院肾内科,广东东莞523900

出　　处：《广州医科大学学报》2021年第1期74-77,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:探究明胶海绵联合微弹簧圈栓塞对颅底骨折伴致命性鼻出血的治疗效果。方法:回顾性分析本院2015年1月-2020年2月收治的颅底骨折伴致命性鼻出血患者60例,根据治疗方式不同分为两组,A组(n=32)采用明胶海绵颗粒联合微弹簧圈栓塞进行治疗,B组(n=28)凡士林纱条对鼻腔进行压迫止血。对比两组治疗后12h后鼻腔出血情况、治疗后1 h、6 h、12 h VAS评分、不良情况发生情况及12h内不适感情况。结果:A组治疗后出血率低于B组(P<0.05);两组在治疗前的VAS评分上的差异无统计学意义(P>0.05),两组在治疗后1 h的VAS评分上的差异无统计学意义(P>0.05),A组在治疗6 h、12 h后的VAS评分均低于B组(P<0.05);两组在不良反应发生率上的差异无统计学意义(P>0.05);A组在12 h内不适感发生率上低于B组(P<0.05)。结论:明胶海绵颗粒联合微弹簧圈栓塞对颅底骨折伴致命性鼻出血的患者止血情况较好,安全性高。Objective:To investigate the therapeutic efficacy of gelatin sponge combined with microcoil embolization on skull base fractures with fatal epistaxis.Methods:A retrospective analysis was performed for 60 cases of skull base fractures with fatal epistaxis admitted to our hospital between January 2015 and February 2020.The patients were divided into two groups according to different treatment methods.The group A(n=32)received gelatin sponge particles plus microcoil embolization,while the group B(n=28)received nasal pressurized packing with vaseline gauze,for hemostasis.The nasal bleeding at 12h after treatment,VAS scores at 1 h,6 h,and 12 h after treatment,adverse conditions,and discomfort within 12h were compared between the two groups.Results:After treatment,group A experienced less bleeding compared with group B(P<0.05).The baseline VAS score did not differ statistically between the two groups(P>0.05),nor did the VAS score at 1h after treatment(P>0.05).The 6h and 12h VAS scores were lower in group A than those in group B(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Group A reported less discomfort compared with group B within 12 hours of the treatments(P<0.05).Conclusion:Gelatin sponge particles combined with microcoil embolization can lead to satisfactory hemostasis in patients with skull base fractures and fatal epistaxis with high safety.

关 键 词：明胶海绵 微弹簧圈栓塞 颅底骨折伴致命性鼻出血 治疗效果 

分 类 号：R651.1[医药卫生—外科学]