Kramann B, Defreyne L, Schneider G, Müller-Bütow N, Kubale R, Engel M, Federspil P
Abteilung für Radiodiagnostik, Radiologische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar.
Rofo. 1997 Jan;166(1):54-61. doi: 10.1055/s-2007-1015378.
To analyse the use of transcatheter embolisation.
We report on 43 patients treated by transcatheter embolisation for head and neck haemorrhage from 1987 to 1995. There were 13 patients with idiopathic intractable epistaxis, 6 with iatrogenic and three with traumatic bleeding, 7 patients with bleeding from vascular malformations, 12 patients with haemorrhage from tumours, one ruptured aneurysm of the inferior thyroid artery and one patient bleeding from a retrolingual dystrophic goitre.
In 11/13 patients with idiopathic epistaxis, this could be stopped. In 8/9 of the traumatic and iatrogenic bleedings the haemorrhage was treated by embolisation alone. In two cases additional elective surgical interventions were necessary. In 6/7 patients with vascular malformations embolisation resulted in long-lasting periods free from bleeding. Palliative embolisation in bleeding tumours resulted in haemostasis in 10/12 patients. Bleeding was definitely stopped in a patient with aneurysm of the inferior thyroidal artery as well as in a patient with bleeding from a dystrophic goitre. We observed a total of three complications, two transitory neurological disturbances and one permanent amaurosis.
Transcatheter embolisation is an effective tool in the treatment of life-threatening head and neck bleedings.
分析经导管栓塞术的应用情况。
我们报告了1987年至1995年间接受经导管栓塞术治疗头颈部出血的43例患者。其中13例为特发性顽固性鼻出血，6例为医源性出血，3例为创伤性出血，7例为血管畸形出血，12例为肿瘤出血，1例为甲状腺下动脉瘤破裂，1例为舌后营养障碍性甲状腺肿出血。
13例特发性鼻出血患者中，11例出血得以止住。9例创伤性和医源性出血患者中，8例仅通过栓塞术治疗出血。2例需要额外进行择期手术干预。7例血管畸形患者中，6例栓塞术后长时间无出血。出血肿瘤的姑息性栓塞术使12例患者中的10例止血。甲状腺下动脉瘤患者以及营养障碍性甲状腺肿出血患者的出血均被彻底止住。我们共观察到3例并发症，2例短暂性神经功能障碍和1例永久性黑矇。
经导管栓塞术是治疗危及生命的头颈部出血的有效手段。
