Elahi M M, Parnes L S, Fox A J, Pelz D M, Lee D H
Department of Otolaryngology, University of Western Ontario, London.
Arch Otolaryngol Head Neck Surg. 1995 Jan;121(1):65-9. doi: 10.1001/archotol.1995.01890010051009.
To determine the effectiveness of therapeutic embolization in the treatment of intractable epistaxis.
Cohort.
Tertiary care hospital.
Consecutive referred sample of 57 patients with intractable epistaxis.
Percutaneous transfemoral catheterization and angiography of the internal maxillary arteries. Embolization of the most distal branches with 0.1- to 0.9- cm3 medium-sized polyvinyl alcohol particles on the suspected side of bleeding.
Outcome was successful if no further interventional treatment was required for epistaxis.
Anatomical abnormalities precluded embolization in three patients. Three of the remaining 54 patients required supplementry embolization. Including these three patients, 52 (96%) of 54 patients had successful control epistaxis. The major neurologic complication rate was 6% (three of 54 patients), with no permanent deficits.
Therapeutic embolization is an effective and safe technique and should be considered as the primary treatment modality in severe epistaxis.
确定治疗性栓塞术治疗难治性鼻出血的有效性。
队列研究。
三级医疗机构。
连续纳入57例难治性鼻出血患者。
经皮股动脉插管及上颌内动脉血管造影。在疑似出血侧用0.1至0.9立方厘米的中型聚乙烯醇颗粒栓塞最远端分支。
若鼻出血无需进一步介入治疗，则治疗成功。
3例患者因解剖异常无法进行栓塞。其余54例患者中有3例需要补充栓塞。包括这3例患者在内，54例患者中有52例（96%）鼻出血得到成功控制。主要神经并发症发生率为6%（54例患者中有3例），无永久性神经功能缺损。
治疗性栓塞术是一种有效且安全的技术，应被视为严重鼻出血的主要治疗方式。
