超选择性动脉栓塞治疗严重鼻出血

Superselective arterial embolization in the treatment of intractable epistaxis

目的观察超选择性动脉栓塞治疗严重鼻出血的临床效果和并发症。方法对22例严重鼻出血患者进行超选择上颌动脉造影,证实出血部位后用明胶海绵、真丝线段栓塞出血动脉。结果22例患者均发现出血动脉,栓塞后达到立即止血目的,1例于栓塞后30min发生右侧眼睛视野中间区域缺损,扩血管、皮下注射肝素钙,注射后30min视野逐渐恢复,3h后视野完全恢复正常。结论超选择性上颌动脉栓塞治疗严重鼻出血具有止血迅速、效果确切、创伤小、恢复快的优点,可作为治疗严重鼻出血的常规手段,在治疗严重鼻出血时应积极使用此项技术。

Objective To observe the clinical effect and complications of superselective transcatheter arterial embolization in the treatment of severe epistaxis. Methods Twenty-two patients with severe epistaxis underwent superselective maxillary artery angiography. When bleeding was confirmed, the arteries were embolized with gelfoam and silk suture. Results Bleeding arteries were found, and the bleeding stopped immediately after embolization in all 22 patients. Central visual field defect developed in the right eye in 1 patient 30 min after embolization, and went better 30 min after vessle dilatation treatment and subcutaneous administration of Heparin Calcium in the umbilicus region. The symptoms disappeared after 3 h. Conclusion Superselective transcatheter arterial embolization is an effective and minimally invasive method with quick patient recovery in the treatment of severe epistaxis and should be considerded as routine treatment and actively employed.