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[上颌动脉超选择性栓塞术在治疗遗传性出血性毛细血管扩张症出血中的应用]

[The use of superselective embolization of the maxillary artery in treatment of bleedings in the Rendu-Osler-Weber syndrome].

作者信息

Kantor Ireneusz, Winiarski Michał, Jurkiewicz Dariusz, Osiecki Mirosław, Brzozowski Krzysztof

机构信息

Klinika Otolaryngologii, Wojskowy Instytut Medyczny w Warszawie.

出版信息

Otolaryngol Pol. 2005;59(2):215-7.

Abstract

Rendu-Osler-Weber syndrome is a rare genetically determined disorder that affects blood vessels throughout the body and results in a tendency for bleeding. Authors describe the case of superselective embolization of the left maxillary artery with polyvinyl alcohol particles in a patient with the Rendu-Osler-Weber syndrome hospitalized and treated in the Department of Otolaryngology and the Department of Radiology of the Military Institute in Warszawa, Poland due to persistent, severe and difficult to manage nasal bleeding. After the procedure had been performed patient condition improved and frequency and severity of nasal bleeding significantly diminished. Authors conclude that superselective embolization of the maxillary artery in a patient with Rendu-Osler-Weber syndrome is safe and effective and can be a valuable alternative to the maxillary artery or the carotis externa artery ligation. Authors also describe other methods of nasal bleeding management: laser photocoagulation, argon plasma coagulation, nasal dermoplasty and pharmacological treatment. Authors indicate that treating patients with Rendu-Osler-Weber syndrome is a diagnostic and therapeutic challenge for a physician and surgeon that require special approach to a patient due to difficult to manage symptoms. Patients with Rendu-Osler-Weber syndrome should be treated in a hospital setting due to access to diagnostic imaging techniques that can be helpful in revealing possible life threatening conditions.

摘要

遗传性出血性毛细血管扩张症是一种罕见的遗传性疾病,会影响全身血管并导致出血倾向。作者描述了一名患有遗传性出血性毛细血管扩张症的患者,因持续性、严重且难以控制的鼻出血,在波兰华沙军事研究所耳鼻喉科和放射科住院治疗,采用聚乙烯醇颗粒对上颌动脉进行超选择性栓塞的病例。手术后患者病情改善,鼻出血的频率和严重程度显著降低。作者得出结论,对遗传性出血性毛细血管扩张症患者进行上颌动脉超选择性栓塞是安全有效的,并且可以成为上颌动脉或颈外动脉结扎术的一种有价值的替代方法。作者还描述了其他鼻出血管理方法:激光光凝、氩等离子体凝固、鼻腔皮肤成形术和药物治疗。作者指出,治疗遗传性出血性毛细血管扩张症患者对内科医生和外科医生来说是一项诊断和治疗挑战,由于症状难以控制需要对患者采取特殊方法。由于可利用诊断成像技术来揭示可能危及生命的状况,遗传性出血性毛细血管扩张症患者应在医院环境中接受治疗。

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