需急诊治疗的外伤性颈内动脉海绵窦瘘

Urgent treatment of the traumatic carotid cavernous fistulae

目的探讨外伤性颈内动脉海绵窦瘘的临床危险因素与治疗对策。方法急诊血管内栓塞治疗的29例具有高危险临床因素的外伤性颈内动脉海绵窦瘘进行回顾性分析。结果10例伴有鼻衄,其中9例治愈,1例入院后2h急性致命性鼻衄而死亡。16例伴有急性视力下降,其中10例治愈,4例改善,2例视力未能恢复。3例伴有颅内出血,均治愈。结论外伤性颈内动脉海绵窦瘘可合并鼻衄、急性视力下降、颅内出血等临床危险因素,这些病症非常凶险,务求及时诊断和彻底治疗。

Objective To study clinical risk factors and urgent treatment of the traumatic carotid cavernous fistula(TCCF). Methods To investigate 29 cases of TCCF retrospectively who required urgent treatment with clinical high risks during the past ten years. Results Among the 10 cases of epistaxis, 9 were cured and 1 with severe epistaxis died of fatal hemorrhage. Among the 16 cases of acute eyesight deterioration, 10 were cured and 4 improved, while 2 cases were unchanged in visual acuity. All 3 cases in the intracerebral hemorrhage group were cured. Conclusions TCCF might be complicated with such high risk factors as epistaxis, intracerebral hemorrhage and acute visual loss. All of the complications are extremely dangerous and need to be diagnosed and treated timely.