鼻咽癌放疗后鼻出血的临床诊治-耳鼻咽喉科学专业论文.docxVIP

PAGE PAGE 2 Clinical diagnosis and treatment of epistaxis after radiotherapy of nasopharyngeal carcinoma Abstract Objective: the clinical characteristics and treatment of nasal hemorrhage after radiotherapy for nasopharyngeal carcinoma.Methods: a retrospective analysis of 13 cases of nasopharyngeal carcinoma after radiotherapy in patients with nasal hemorrhage clinical data, methods of hemostasis were treated conservatively, packing, anterior naris anterior and posterior nasal packing, endoscopic therapy, nasopharyngeal clear + biopsy, digital subtraction carotid artery angiography and embolization.Results: 13 cases of patients with nasal bleeding, 12 cases, 1 cases received conservative treatment, 2 cases of anterior naris packing for hemostasis, 2 cases of anterior and posterior nasal packing to stop bleeding, 1 cases with ND:YAP laser under nasal endoscope hemostasis, 3 cases of nasal endoscopic electrocoagulation + nasal packing hemostasis, 2 cases of digital subtraction angiography hemostasis + selective arterial embolization; 1 cases of nasopharyngeal crusts and granulation tissue debridement hemostasis, were satisfied with bleeding effect.The other 1 patients because of sudden bleeding after rescue invalid, died of suffocation;Conclusion: Epistaxis after radiotherapy of nasopharyngeal carcinoma is a special type of nasal bleeding, compared with normal nasal bleeding has its characteristics: rapid, repeated hemorrhage, bleeding volume, not easy to control, life-threatening, prone to severe complications, the mortality rate is high, according to its characteristics and the corresponding changes of various hemostatic method is reasonable and effective and timely is the key to improve the success rate of rescue. [keyword] Nasopharyngeal carcinoma； radiotherapy； nasal bleeding. 引言 鼻咽癌是我国常见的恶性肿瘤之一，尤其在广东、海南、广西、福建、湖南、 江西等高发区，其发病率男性达30/10万以上，女性也超过15/10万[1]。目前放射 性治疗是治疗鼻咽癌的主要手段之一，通过放化疗等综合治疗，鼻咽癌的平均五 年生存率可达60%左右[2]。在鼻咽癌放射治疗的同时，由放疗引起的相关并发症 也逐渐引起大家广泛的重视。其中鼻出血是重要及常见的并发症之一