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目的分析急诊介入栓塞法在控制外伤所致的鼻腔大出血的临床治疗价值。方法 10例外伤所致的鼻腔大出血者,在DSA明确出血靶动脉后用栓塞材料(聚乙烯醇颗粒、明胶海绵、球囊、弹簧圈)行急诊出血靶动脉栓塞术。结果 10例患者中单纯颌内动脉损伤者5例,面动脉分支供血1例,颈内外动脉交通(翼管动脉)1例,颈内动脉海绵窦瘘1例,颈内动脉假性动脉瘤1例,颈内动脉海绵窦瘘合并颈内动脉假性动脉瘤1例。成功行损伤靶动脉栓塞术10例。栓塞术后鼻口腔活动性出血在4h内均停止。10例患者在栓塞24h后生命体征均趋平稳,所有患者均经康复治疗后顺利出院。结论栓塞术可在微创的情况下解决外伤性严重鼻出血。
Objective To analyze the clinical value of emergency interventional embolization in the control of traumatic nasal hemorrhage. Methods Ten cases of nasal haemorrhage caused by trauma were treated with emergency bleeding target artery embolization with polyvinyl alcohol granules, gelatin sponge, balloon and coil after the DSA had a definite bleeding target artery. Results Among the 10 patients, 5 cases had simple internal carotid artery injury, 1 case had branch artery blood supply, 1 case had internal and external arterial traffic (wing artery), 1 had carotid cavernous fistula, 1 had carotid artery pseudoaneurysm 1 Cases, internal carotid cavernous fistula with pseudoaneurysm of internal carotid artery in 1 case. Successfully injured target artery embolization in 10 cases. Occlusive nasal active bleeding within 4h after stopping. The vital signs of 10 patients stabilized after embolization 24h, all patients were discharged smoothly after rehabilitation. Conclusion Embolization can be used to solve severe traumatic epistaxis with minimally invasive surgery.