血管内栓塞治疗顽固性鼻出血的中远期疗效分析

目的探讨经血管内栓塞治疗顽固性鼻出血的中远期疗效,评价其临床应用价值。资料与方法搜集2005年3月至2010年3月采用血管内栓塞治疗顽固性鼻出血的患者52例,回顾分析其临床资料及随访结果。结果 52例中,失访8例,随访44例(3~60个月,平均42个月)。鼻咽部血管瘤19例,其中2例5年内复发出血;鼻肉瘤2例,其中1例3个月后因基础疾病诱发鼻腔大出血死亡;鼻咽癌6例,其中2例术后1个月复发出血,第二次栓塞后随访3个月无复发,6个月后因基础疾病复发大出血死亡;高血压6例,其中2例术后1个月复发大出血,常规治疗后止血,术后5年内血压升高时即间断少量渗血;鼻中隔术后4例,栓塞后无出血;无诱因出血7例,其中1例1个月内饮酒诱发鼻出血;36例随访3~60个月均无复发出血。短期止血率100%(≤7天),中远期止血率82%(36/44)。结论血管内栓塞治疗顽固性鼻出血短期疗效显著;根据基础疾病不同,其中远期疗效差异明显;栓塞材料的选择及介入超选择插管技术对中远期疗效有重要意义。

The Medium-Long Term Clinical Application of Endovascular Embolisation in Treating Intractable Epistaxis

Objective To summarize the medium-long term clinical efficiency of endovascular embolization in treatment of intractable epistaxis.Materials and Methods Fifty-two patients with intractable epistaxis were treated by thranscatheter arterial embolization(TAE) with polyvinyl alcohol(PVA) or gelatin sponge.Forty-four patients were followed up and analyzed from Mar 2005 to Mar 2010 retrospectively.Results Eight patients were lost follow-up.Forty-four patients were followed up from three to sixty months with media...