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作 者:李臻[1] 余鹏 李鑫[1] 李腾飞[1] 王若愚[2] 周朋利[1] 叶书文 周纪妹 王玲[1] 谢炳灿 于琦 LI Zhen;YU Peng;LI Xin;LI Tengfei;WANG Ruoyu;ZHOU Pengli;YE Shuwen;ZHOU Jimei;WANG Ling;XIE Bingcan;YU Qi(Department of Interventional Radiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)
机构地区:[1]河南省微创介入工程技术研究中心、郑州大学第一附属医院放射介入科,河南郑州450052 [2]河南省微创介入工程技术研究中心、郑州大学第一附属医院急诊外科,河南郑州450052
出 处:《介入放射学杂志》2023年第7期632-637,共6页Journal of Interventional Radiology
摘 要:目的 探讨急诊介入治疗头颈部难治性出血的可行性、安全性及疗效。方法 回顾性总结2016年4月至2021年4月郑州大学第一附属医院介入科收治的86例头颈部难治性出血患者临床资料,男62例、女24例,年龄12~79岁,平均(53.7±15.0)岁。患者均因保守治疗效果差而转行介入治疗。分析患者临床资料、有效止血率、临床成功止血率、住院期间再出血和离院复发原因及并发症。结果 急诊介入治疗有效止血率为96%(83/86),临床成功止血率为91%(79/86),住院期间再出血6例,离院复发12例。术后24 h内几乎所有患者均出现不同程度的口腔颌面部轻微疼痛、肿胀或皮肤色泽改变等栓塞后综合征。1例术后6 h发生右侧大面积脑梗死。随访(3~24个月)期间,7例因再发大出血而死亡,21例因肿瘤进展死亡。结论 介入治疗头颈部难治性出血疗效确切,技术安全、可行,并发症少,能挽救患者生命。Objective To investigate the feasibility,safety and efficacy of emergency interventional treatment for the refractory bleeding at head and neck region.Methods The clinical data of 86 patients with refractory hemorrhage at head and neck region,who were admitted to the Interventional Department of the First Affiliated Hospital of Zhengzhou University of China between April 2016 and April 2021,were retrospectively analyzed.All the patients received interventional treatment due to the poor efficacy of conservative treatment.The patients included 62 males and 24 females,with a mean age of(53.7±15.0)years(12-79 years).The clinical data,effective hemostasis rate,clinically successful hemostasis rate,causes of rebleeding during hospitalization and after discharge from hospital,and complications were analyzed.Results The effective hemostasis rate of emergency intervention was 96%(83/86),and the clinically successful hemostasis rate was 91%(79/86).Rebleeding during hospitalization and after discharge from hospital was seen in 6 patients and 12 patients respectively.Within 24 hours after treatment,almost all patients developed different degrees of post-embolization syndrome symptoms,including mild oral and maxillofacial pain,swelling,skin color change,etc.Large area cerebral infarction on the right side occurred in one patient at six hours after treatment.During the follow-up period of 3-24 months,7 patients died of recurrent massive hemorrhage and 21 patients died of tumor deterioration.Conclusion For the refractory bleeding at head and neck region,interventional treatment is technically-safe and clinically-feasible with reliable effect and less complications,and it can save patient’s live.(J Intervent Radiol,2023,32:632-637)
分 类 号:R765.23[医药卫生—耳鼻咽喉科]
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