Vitek J
Department of Radiology, University of Alabama, Birmingham 35233.
Radiology. 1991 Oct;181(1):113-6. doi: 10.1148/radiology.181.1.1887018.
Thirty patients with intractable idiopathic epistaxis were treated with endovascular therapy. Embolization of the internal maxillary artery controlled the epistaxis in 87% of the patients, and the success rate was increased to 97% after supplemental embolization of the facial artery. The only complication observed was transient postembolization hemiparesis, which occurred in one of the 30 patients. Intractable idiopathic epistaxis is defined as epistaxis of unknown cause that is refractory to nasal packing. Such epistaxis is commonly treated with surgical intervention, including ligation of the terminal segments of the internal maxillary artery and the ethmoid arteries. An alternative approach is performance of endovascular therapy. In our opinion, embolization is a safe and effective procedure when it is carried out by appropriately trained personnel. In most patients, its performance requires use of only neuroleptanalgesia; surgery can be avoided, and the duration of hospitalization is significantly shortened. We recommend that embolization be adopted as the primary modality for the treatment of idiopathic intractable epistaxis.
30例顽固性特发性鼻出血患者接受了血管内治疗。上颌内动脉栓塞控制了87%患者的鼻出血，在对面动脉进行补充栓塞后成功率提高到97%。观察到的唯一并发症是栓塞后短暂性偏瘫，发生在30例患者中的1例。顽固性特发性鼻出血定义为原因不明且对鼻腔填塞难治的鼻出血。此类鼻出血通常采用手术干预治疗，包括结扎上颌内动脉终末段和筛动脉。另一种方法是进行血管内治疗。我们认为，由经过适当培训的人员进行栓塞是一种安全有效的操作。在大多数患者中，操作仅需使用神经安定镇痛法；可避免手术，且住院时间显著缩短。我们建议将栓塞作为特发性顽固性鼻出血的主要治疗方式。
