Zhang Ping, Chu Yong, Luo Yanyun, Yang Houming
Department of Otolaryngology, Wuhan General Hospital, Guangzhou Military Region, Wuhan 430070.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2003 Nov;17(11):657-9.
To learn the effects and the correlative factors of selected transarterial embolization in treatment of uncontrolled epistaxis.
The abnormal ends of internal maxillary artery were selected embolized in 23 patient of uncontrolled epistaxis by digital subtraction angiography (DSA) of carotid, meanwhile the facial artery were also embolized in 5 patients.
It was confirmed that hypogenesis and malformation in the ends of internal maxillary artery were existed in all 23 cases during DSA. There was evidence of bleeding in 15 patients, and facial artery with abnormal shape was found in 6 patients. Nose-bleeding was stopped in 22 cases (95.6%) after embolized, including one had a recurrence of bleeding in 24 hours because of the foundation of new abnormal communications. The fail in one case might be related with taking out all the stuff in noses before embolization and/or bleeding facial artery.
Uncontrolled epistaxis in this report might be caused by hypogenesis and malformation of internal maxillary artery. The effects of selected transarterial embolization were rapid and satisfactory. The fail in treatment might be related to foundation of new abnormal communications and bleed from facial artery. Taking out all the stuff in noses too early might also influence the effects of embolization.
探讨选择性动脉栓塞术治疗难治性鼻出血的疗效及相关因素。
对23例难治性鼻出血患者行颈动脉数字减影血管造影（DSA），选择上颌动脉异常末端进行栓塞，其中5例同时栓塞了面动脉。
DSA检查证实23例患者均存在上颌动脉末端发育不全及畸形。15例有出血征象，6例发现面动脉形态异常。栓塞后22例（95.6%）鼻出血停止，其中1例因新的异常交通形成于24小时后再次出血。1例失败可能与栓塞前清除鼻腔内所有填塞物和/或面动脉出血有关。
本研究中的难治性鼻出血可能由上颌动脉发育不全及畸形引起。选择性动脉栓塞术疗效迅速且满意。治疗失败可能与新的异常交通形成及面动脉出血有关。过早清除鼻腔内所有填塞物也可能影响栓塞效果。
