血管内栓塞治疗顽固性鼻衄的临床分析(附29例报告)

Clinical analysis of endovascular embolization in the treatment of intractable epistaxis(report of 29 cases)

目的探讨血管内栓塞顽固性鼻衄的血管造影解剖特点、临床疗效及并发症的预防。方法选取我院2015年1月~2017年1月29例顽固性鼻衄患者采用Seldinger技术,股动脉插管,超选择颈内、外动脉造影后,经微导管行病变动脉的栓塞治疗。结果颈外动脉分支出血27例,2例颈内动脉眼动脉筛前支出血。行33次栓塞,其中23例单侧单次栓塞,4例双侧颈外动脉分支栓塞,2例单侧颈内动脉眼动脉筛前支栓塞,止血成功率100%。1例右颈内动脉眼动脉筛前支栓塞后右眼失明。16例栓塞术后有不同程度的头痛表现。结论动脉栓塞是一种治疗顽固性鼻衄安全、有效的方法,充分了解其解剖结构,超选择插管,精细栓塞可减少和避免并发症的发生。

0bjective To investigate the angiographic features,clinical efficacy and complications of intranasal embolization of intractable epistaxis. Methods 29 patients with intractable epistaxis were selected from January 2015 to January 2017 in xiaolan people＇s hospital affiliated to southern medical university.After using Seldinger technique,femoral artery intubation,super selection of internal carotid and external arteriography,transcatheter arterial embolization was performed by the micro catheter. Results There were 27 cases of branch hemorrhage of external carotid artery and 2 cases of anterior branch hemorrhage of internal carotid artery.33 times of embolization were performed,including 23 unilateral unilateral embolization,4 bilateral external carotid artery embolization,and 2 unilateral internal carotid artery anterior ethmoid branches embolization.The success rate of hemostasis was 100%.Right eye blindness after embolization of anterior branch of ophthalmic artery of right internal carotid artery in 1 cases.16 cases had different degrees of headache after embolization. Conclusion Arterial embolization is a safe and effective treatment for intractable epistaxis.Fully understand the anatomical structure,superselective catheterization and embolization can reduce and avoid the occurrence of fine complications.