Meaudre E, Bordes J, Prunet B, Cathelinaud O, Kenane N, Palmier B, Goutorbe P
Département d'anesthésie-réanimation, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France.
Ann Fr Anesth Reanim. 2008 Mar;27(3):252-5. doi: 10.1016/j.annfar.2007.11.024. Epub 2008 Feb 12.
Life-threatening bleeding following craniofacial injury is rare. The rich collateral circulation between external and internal carotid arteries complicates the problem of controlling haemorrhage. We report the case of a 63-year-old man who presented a life-threatening haemorrhage following maxillofacial trauma and a severe head injury with subdural haematoma requiring neurosurgical evacuation. Although we had an interventional radiology unit, facial haemostasis was achieved by an unilateral ligation of the external carotid artery. There were three reasons behind our decision: multiple bleeding excluding selective endovascular embolization, efficiency and speed of the ligation of the external carotid, only one place for this cephalic surgery in two phases (neurosurgery and neck surgery). The role of ligation of the external carotid artery for life-threatening bleeding following facial injury is discussed.
颅面损伤后危及生命的出血较为罕见。颈外动脉和颈内动脉之间丰富的侧支循环使控制出血的问题变得复杂。我们报告了一例63岁男性患者，其在颌面部创伤和严重头部损伤伴硬膜下血肿需要神经外科引流后出现危及生命的出血。尽管我们有介入放射科，但通过单侧结扎颈外动脉实现了面部止血。我们做出这一决定有三个原因：多处出血排除了选择性血管内栓塞、颈外动脉结扎的效率和速度、该头颅手术分两个阶段（神经外科和颈部手术）只有一个部位。本文讨论了颈外动脉结扎在面部损伤后危及生命的出血中的作用。
