Bergler W, Riedel F, Baker-Schreyer A, Juncker C, Hörmann K
University Hospital, Department of Otorhinolaryngology, Mannheim, Germany.
Laryngoscope. 1999 Jan;109(1):15-20. doi: 10.1097/00005537-199901000-00004.
Patients with (HHT) often suffer from recurrent epistaxis, which poses considerable therapeutic problems. Theoretical considerations render argon plasma coagulation (APC) a promising new therapeutic approach.
In a prospective study 12 patients (aged 8-68 y) who presented with a long history of treatment for epistaxis were treated with telangiectasia in the nasal mucosa. After 2 weeks and again after 4 months the treatment results were evaluated by questionnaire.
APC is based on high-frequency electric energy transmitted through ionized argon gas to the tissue in a noncontact mode. Coagulation and desiccation of tissue are limited to 1 to 2 mm of penetration and therefore risk of tissue damage is low. Coagulative effects are best in tissue with high electrical conductivity, especially blood vessels.
All patients were satisfied with the postoperative results. Frequency and intensity of bleeding were significantly reduced. All patients reported better postoperative results than with any other treatment they had received previously.
First clinical experience shows that APC is a useful alternative for the treatment of telangiectasia in the nasal mucosa and should be a therapeutic option for this disease.
遗传性出血性毛细血管扩张症(HHT)患者常反复鼻出血,这带来了相当大的治疗难题。理论上,氩等离子体凝固术(APC)是一种有前景的新治疗方法。
在一项前瞻性研究中,对12例(年龄8 - 68岁)有长期鼻出血治疗史且伴有鼻黏膜毛细血管扩张的患者进行治疗。在2周后以及4个月后通过问卷调查评估治疗效果。
APC基于高频电能通过电离氩气以非接触模式传输到组织。组织的凝固和干燥限于1至2毫米的穿透深度,因此组织损伤风险较低。在高电导率的组织中,尤其是血管,凝固效果最佳。
所有患者对术后结果满意。出血频率和强度显著降低。所有患者均表示术后效果优于他们之前接受的任何其他治疗。
初步临床经验表明,APC是治疗鼻黏膜毛细血管扩张症的一种有用替代方法,应成为该疾病的一种治疗选择。