介入止血在鼻咽癌放疗后大出血治疗中的应用  

Application of interventional hemostatic therapy in the treatment of massive hemorrhage after radiotherapy for nasopharyngeal carcinoma

作　　者：刘宇洲 孙林[1] 向斌 谢勇 向华[1] LIU Yuzhou;SUN Lin;XIANG Bin;XIE Yong;XIANG Hua(Department of Interventional Vascular Surgery,First Affiliated Hospital of Hunan Normal University(Hunan Provincial People's Hospital),Changsha,Hunan Province 410005,China)

机构地区：[1]湖南师范大学附属第一医院(湖南省人民医院)介入血管外科,湖南长沙410005

出　　处：《介入放射学杂志》2023年第2期145-148,共4页Journal of Interventional Radiology

基　　金：湖南省急危重症急救能力提升与突发公共卫生应急救治关键技术协同创新工程项目(2020SK1010)。

摘　　要：目的 探讨介入止血治疗鼻咽癌放疗后大出血的有效性和安全性。方法 回顾性分析2015年至2021年湖南省人民医院收治的16例鼻咽癌放疗后大出血患者临床资料。9例患者接受颈外动脉分支栓塞术,2例接受单侧颈内动脉栓塞术,3例接受颈内动脉覆膜支架隔绝术,2例未接受介入止血治疗。结果 14例患者介入止血治疗后13例为有效止血,1例止血失败。术后随访时间3 d至71个月,其间患者均无再次出血,1例出现脑缺血症状后死亡。结论 鼻咽癌放疗后大出血介入治疗可准确、迅速止血,但对于颈内动脉破裂出血需进一步改进术式,以减少并发症发生概率,提高患者生存率。ObjectiveTo investigate the efficacy and safety of interventional hemostatic therapy in the treatment of massive hemorrhage after radiotherapy for nasopharyngeal carcinoma.MethodsThe clinical data of 16 patients with nasopharyngeal carcinoma,who developed massive hemorrhage after receiving radiotherapy at the Hunan Provincial People's Hospital of China between 2015 and 2021,were retrospectively analyzed.Of the 16 patients,9 received external carotid artery embolization,2 received unilateral internal carotid artery embolization,3 received internal carotid artery isolation therapy with covered stent,and 2 didn’t receive interventional hemostatic therapy.ResultsAmong the 14 patients who received interventional hemostatic therapy,effective hemostasis was obtained in 13 and failure to stop bleeding was seen in one.After treatment,the patients were followed up for 3 days to 71 months.During the follow-up period,no recurrence of bleeding occurred and one patient died of cerebral ischemia.Conclusion For the treatment of massive hemorrhage after radiotherapy of nasopharyngeal carcinoma,interventional hemostatic therapy can achieve accurate and rapid hemostasis.However,for internal carotid artery rupture with bleeding,the surgical way needs to be further modified so as to reduce the incidence of complications and improve the survival rate.

关 键 词：鼻咽癌 出血 介入栓塞 覆膜支架 

分 类 号：R739.63[医药卫生—肿瘤]