头面部外伤性假性动脉瘤致鼻出血的诊治.pdf

中国耳鼻咽喉头颈外科/2007年7月,第14卷,第7期 论 著 头面部外伤性假性动脉瘤致鼻出血的诊治 余得志，邱建新，沙群，杨见明，陶冶，曹卫 （安徽医科大学第一附属医院耳鼻咽喉头颈外科，安徽　合肥　230022） [摘 要]　目的　探讨外伤性假性动脉瘤引起顽固性鼻出 University, Hefei, Anhui, 230022, China) 方法 血的临床诊断思路。 　选择16例外伤后假性动脉瘤 Corresponding author: QIU Jianxin (Email: qiujianxin@ 病例，男性12例，女性4例，年龄16～4 1岁，平均25.4 ) 结果 岁，回顾性分析该组病例鼻出血的临床特点。 　该 [ABSTRACT]　OBJECTIVE　To study the diagnosis 组病例1例死亡，其他患者行血管造影栓塞治疗后均痊愈 and management of epistaxis caused by traumatic 出院。患者自入院到通过行数字减影血管造影 （digital pseudoaneurysm. METHODS　 The clinical data subtraction angiography ，DSA ）检查明确诊断为假性 of 16 cases with epistaxis caused by traumatic 动脉瘤相隔时间最短为3天，最长为15天，平均为4 .5 pseudoaneurysm were retrospectively studied. There 天，患者均有多次行前后鼻孔填塞病史，填塞的次数最 were 12 males and 4 females. Their ages ranged 少1次，最多达5次，平均2.5次。结论　外伤后反复大量 from 16 to 41 years with an average of 25.4 years. 鼻腔出血患者如行前后鼻孔填塞止血效果差，应尽早行 RESULTS　A ll t he pat ients were cured v ia digital DSA检查，明确有无假性动脉瘤存在，诊断明确后行血 subtraction angiogrophy (DSA) and embolization except 管造影栓塞治疗。尽可能避免盲目多次的前后鼻孔填塞 one died. The time between the hospitalization and 给患者带来的痛苦，同时也可有效避免因延误诊断造成 the DSA examinat ion was 3 to15 days. Interestingly, 假性动脉瘤破裂致患者出血死亡的可能。 every patient had received anterior and posterior nasal [关键词]　鼻出血；动脉瘤，假性；血管造影术，数字 packing one to 5 times. CONCLUSION　If the anterior 减影；栓塞，治疗性 and posterior nasal packing were not effective to the patients with repeated and vast nasal bleeding, who Diagnosis and management of epistaxis caused by had trauma history before nasal bleeding, the DSA traumatic pseudoaneurysm exami