超选择性全脑血管造影及栓塞治疗外伤性顽固鼻腔大出血

目的：探讨外伤性顽固性鼻腔大出血行超选择性全脑血管造影及血管内栓塞治疗临床应用价值。方法：回顾分析34例患者全脑血管造影与超选择性血管内栓塞治疗的资料。结果：27例颈外动脉分支出血，其中1例蝶腭动脉伴副脑膜动脉同时破裂出血；7例发生颈内动脉海绵窦瘘；微导管超选择性靶血管插管后采用明胶海绵、PVA颗粒、弹簧圈、可脱性球囊等栓塞；2例再发鼻出血经填塞后缓解，其余一次栓塞止血成功；1例术后发生偏盲。结论：全脑血管造影是明确外伤性顽固鼻腔大出血责任血管的“金标准”，超选择性血管内栓塞是微侵袭、安全、有效的首选治疗方法。

Super-selective cerebral arteriography and endovascular embolization in the treatment of intractable epistaxis caused by traumatic

Objective： To evaluate the clinical value of super-selective cerebral arteriography and endovascular embolization in the treatment of intractable epistaxis caused by traumatic lesions. Method：The clinical data of 34 cases undergoing super-selective cerebral arteriography and endovascular embolization were analyzed retrospectively. Result：Branches of the external carotid artery with hemorrhage in 27 cases,of them, 1 case of sphenopalatine artery hemorrhage companied with rupture and bleeding of accessory meningeal artery; 7 cases with internal carotid-cavernous fistulas; Gelfoam.PVA particle.micro coils and detachable balloons were injected into the bleeding arteries under microcatheter superselective catheterization;2 cases in recurring hemorrhage which was alleviated after packing; 1 case in postoperative hemianopsia and the others were cured after 1 time of super selective endovascular embolization. Conclusion：Cerebral arteriography is the gold standard of identifying the relevant vessels accurately of intractable epistaxis caused by trauma and super-selective endovascular embolization is safe,minimally invasive and effective in the treatment of intractable epistaxis.