经导管动脉栓塞术治疗急性顽固性鼻腔大出血的可行性

Feasibility of transcatheter arterial embolization in treating acute massive intractable epistaxis

目的探讨经导管动脉栓塞治疗急性顽固性鼻腔大出血的可行性。方法对17例顽固性鼻腔大出血患者采用Seldinger技术经股动脉穿刺,送入4~5 F VER导管,行全脑血管及选择性血管造影,对出血血管进行分析、诊断,采用聚乙烯醇（PVA）及明胶海绵超选择性栓塞出血血管,栓塞后立即拔出鼻腔填塞物观察出血是否停止。结果 17例患者一次栓塞成功,未发生与操作相关的严重并发症。栓塞后住院观察6~14 d后痊愈出院。随访1~3个月均无再次出血,亦无相关并发症发生。结论经导管动脉栓塞术治疗急性顽固性鼻腔大出血安全、可靠,疗效肯定,尤其在保守治疗无效时应作为首选的治疗方法。

Objective To explore the feasibility of transcatheter arterial embolization（TAE） in treating acute massive intractable epistaxis（AMIE）.Methods 17 patients with clinical manifestation of AMIE initially underwent whole brain vascular and selective target vessel angiography,which was performed by at puncturing femoral artery and inserting 4-5F VER catheter into hemorrhagic artery with seldinger technique for identifying hemorrhagic vessel and then underwent TAE with PVA and gelatin sponge,pulled-out nasal packing material immediately after embolization and observed carefully whether epistaxis stoped.Results TAE were proved successful at the first time in all patients.There were no severe complications related to the procedure.All patients were cured and discharged from hospital 6-14 days after TAE.No epistaxis recurrence and TAE-related complication were found during follow-up for 1-3 months.Conclusion TAE is a safe,reliable and high-effective method to treat AMIE,especially for patients failed in conservative treatment.