血管内栓塞治疗鼻咽癌放疗后鼻及鼻咽部大出血

Clinical application of intravascular embolization in nasal and nasopharyngeal massive hemorrhage after radiotherapy in nasopharygeal cancer

目的:探讨经血管栓塞治疗鼻咽癌放疗后鼻及鼻咽部大出血的临床应用价值.方法:对我院7例鼻咽癌放疗后鼻及鼻咽部大出血患者采用经股动脉穿刺行双侧颈内、外动脉造影,明确出血部位及出血动脉,以明胶海绵、弹簧钢圈及可脱球囊等材料进行选择性颈内动脉或颈外动脉及其分支血管栓塞.结果:7例介入栓塞治疗均获成功.其中有6例经过介入及临床综合治疗7～10天后治愈出院,1例介入治疗后第2天因消化道应激溃疡出血停用抗凝药及激素后,出现广泛脑梗死死亡.结论:鼻咽癌放疗后鼻及鼻咽部大出血采用明胶海绵、弹簧钢圈及可脱性球囊等材料栓塞治疗效果肯定,值得推广应用.

Objective:To explore the clinical application of intravascular embolization in nasal and nasopharygeal massive hemorrhage after radiotherapy in nasopharyngeal cancer.Methods:7 patients with nasal and nasopharyngeal massive hemorrhage after radiotherapy for nasopharygeal cancer underwent femoral puncture and bilateral internal and external carotic arteriography.Sites of bleeding arteries were found.Selective embolization were done with gelatin sponge,spring steel coil or detachable ballon.Results:All of 7 patients received embolization therapy successfully.6 of 7 patients were cured and discharged from the hospital after interventional and clinical comprehensive therapy.1 patient presented digestive tract bleeding due to stress ulcer on the 2nd day after interventional therapy,so administration of anticoagulant and steroid had stopped.Finally this patient died of extensive cerebral infarction.Conclusion:Gelatin sponge,spring steel coil and detachable ballon can be the effective material for intravascular embolization in nasal and nasopharygeal massive hemorrhage after radiotherapy in nasoplarygeal cancer.