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经动脉栓塞术治疗颌面部创伤后危及生命的出血:病例报告及文献复习

Transarterial embolization in the management of life-threatening hemorrhage after maxillofacial trauma: a case report and review of literature.

作者信息

Liu Wei-Hsiu, Chen Yuan-Hao, Hsieh Cheng-Ta, Lin En-Yuan, Chung Tzu-Tsao, Ju Da-Tong

机构信息

Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan, Republic of China.

出版信息

Am J Emerg Med. 2008 May;26(4):516.e3-5. doi: 10.1016/j.ajem.2007.07.036.

Abstract

There are many reasons for hypotension in trauma patients. Life-threatening hemorrhage associated with maxillofacial trauma is considered rare. Here, we present a 25-year-old patient with maxillofacial trauma complicated by life-threatening hemorrhage after a traffic accident. At the emergency department, massive epistaxis was noted. Nasal packing and blood transfusion were performed, but vital signs of the patient were still unstable. Cerebral angiography revealed contrast extravasation from the left superficial temporal and internal maxillary arteries of the left external carotid artery. After transarterial embolization was performed, the hemorrhage immediately stopped. When common treatment such as nasal packing, correction of coagulopathy, reduction of fractures, and arterial ligation fails to control the hemorrhage, transarterial embolization can offer a safe alterative to surgical exploration.

摘要

创伤患者发生低血压的原因有很多。与颌面创伤相关的危及生命的出血被认为很罕见。在此,我们报告一名25岁的交通事故患者,其颌面创伤并发危及生命的出血。在急诊科,发现大量鼻出血。进行了鼻腔填塞和输血,但患者的生命体征仍不稳定。脑血管造影显示左侧颈外动脉的左颞浅动脉和上颌内动脉有造影剂外渗。经动脉栓塞术后,出血立即停止。当鼻腔填塞、纠正凝血障碍、骨折复位和动脉结扎等常规治疗无法控制出血时,经动脉栓塞可为手术探查提供一种安全的替代方法。

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