颈动脉海绵窦瘘并鼻腔大出血的血管栓塞及蝶窦肌浆填塞术  

Successful cure of carotid cavernous fistula with life-threatening apistaxis by intravascular embolism and muscle paste plugging in sphenoid sinus

作　　者：梁勇[1] 李湘平[1] 张威[1] 彭玉平[2] 

机构地区：[1]第一军医大学附属南方医院耳鼻咽喉科,广州510515 [2]第一军医大学附属南方医院神经外科

出　　处：《临床耳鼻咽喉科杂志》2004年第4期227-228,T001,共3页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :探讨颈动脉海绵窦瘘伴鼻腔大出血的治疗途径。方法 :1例经影像学诊断为鞍区肿瘤侵入到海绵窦和蝶窦的患者 ,在行经鼻入路手术时因损伤颈动脉导致颈动脉海绵窦瘘而相继引起二次鼻腔大出血 ,给予数字血管减影和血管内栓塞以及经鼻内镜蝶窦内肌浆填塞等处理。结果 :患者成功治愈 ,经术后 8个月的随访表明局部肌浆存活 ,愈合良好 ,未再发生出血。结论 :颈动脉海绵窦瘘引起的鼻腔大出血在经过紧急处理后 ,血管内栓塞和经鼻内镜行蝶窦内肌浆填塞为一种可供选择和有效的治疗方法。Objective:To report a successfully healed case of carotid cavernous fistula with life-threatening epistaxis by intravascular embolism and muscle paste plugging in sphenoid sinus.Method:The patient was found a tumor in sella turcica by imaging, invading into cavernous sinus and sphenoid sinus. During operation,the internal carotid artery was ruptured, and two times of life-threatening apistaxis were happened. The digital subtraction angiography and intravascular embolism were carried out two times, then, muscle paste was plugged into sphenoid sinus via nasal endoscopy.Result:The patient was successfully healed. And a flowing up of 8 months showed that epistaxis did not occur again and muscle paste was survival in sphenoid sinus.Conclusion:After emergent managements such as nasal plugging and transfusion for epistaxis caused by carotid cavernous fistula, the intravascular embolism, muscle paste plugging in sphenoid sinus under transnasal endoscopic surgery were an available and effective management.

关 键 词：颈动脉海绵窦瘘 鼻出血 栓塞 治疗性 肌浆填塞 

分 类 号：R730.264[医药卫生—肿瘤]