鼻咽癌放疗后鼻咽大出血45例分析  

Analysis of 45 nasopharyngeal cancer patients with intractable epistaxis after radiotherapy

作　　者：廖遇平[1] 洪继东[1] 王学伟[1] 姜武忠[1] 涂青松[1] 章正[1] 

机构地区：[1]中南大学湘雅医院放疗科,湖南长沙410008

出　　处：《中国耳鼻咽喉颅底外科杂志》2004年第1期28-29,32,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的　研究鼻咽癌放疗后发生鼻咽大出血的原因及抢救措施。方法　本文收集 4 5例经病理证实的鼻咽癌放疗后鼻咽大出血病人 ,其中复发再治占 77.8% ,抢救方法主要包括后鼻孔填塞、鼻前野放射和颈外动脉结扎术。结果　 2 1例 (46 .7% )抢救成功 ,2例急性大出血的尸体解剖结果表明出血是与肿瘤侵蚀颈内动脉有关。鼻咽癌放疗后合并鼻咽大出血者预后凶险。结论　后鼻孔填塞、颈外动脉结扎、鼻前野放射止血及血管栓塞术是目前可行的主要止血措施。出血控制后要加强对鼻咽原发灶的治疗才能提高疗效。Objective To study the causes and critical care on intractable epistaxis in Patients with Nasopharyngeal cancer after radiotherapy. Methods A series of 45 cases with intractable epistaxis in pathology proven Nasopharyngeal cancer patients after radiotherapy. Among them 77.8% recurred and received a second treatment. Critical care methods included: filling up postnasoforamin, prenasal field irradiation, ligating the external carotic artery. Results 21 cases ( 46.7% ) were saved successfully. The findings in 2 autopsies inducted that bleeding could be the destruction of the internal carotic artery due to tumor. Conclusion Filling up postnasoforamen and/or prenasal field irradiation, and Percutaneous embolization are main workable methods for stopping bleeding at present. After bleeding was under controll it is necessary to treat primary nasopharyngeal focus in order to improve final effect.

关 键 词：鼻咽癌 放射治疗 鼻咽大出血 

分 类 号：R730.55[医药卫生—肿瘤]