选择性动脉栓塞治疗急性顽固性鼻出血

目的：探讨经导管选择性动脉栓塞治疗急性顽固性鼻出血的介入操作技术、临床疗效及并发症的防治策略。方法：回顾性分析34例急性顽固性鼻出血患者的临床资料,全面的血管造影后,选择适当栓塞材料栓塞双侧病变区供血动脉血管床,随访30d观察动脉栓塞疗效及并发症。结果：34例患者均成功完成血管内栓塞治疗,技术成功率为100%,31例栓塞后活动性出血停止或明显减少,治疗有效率91.17%。2例（6.25%）栓塞后1个月内复发出血。19例（55.9%）术后出现颜面部麻木、肿疼、张口受限等轻度并发症,1例（2.94%）术后肿疼明显须对症治疗缓解,无严重并发症发生。结论：经导管双侧动脉内栓塞是治疗急性顽固性鼻出血的有效介入方法,细致、规范操作和栓塞材料的合理选择是保证治疗安全的有效手段。

Efficacy of selective percutaneous arterialembolization for the treatment of acute and intractable epistaxis

Objective：To evaluate the efficacy and complications of transarterial embolisation in the treatment of acute and intractable epistaxis.Method：34patients with acute and intractable epistaxis who had been treated by transarterial embolization were followed up for 30days.Bleeding and clinical complications were observed to evaluate the therapeutic efficacy.Result：34（100%）patients were successfully finished their procedure.Oronasal hemorrhage was completely controlled or obviously reduced in 31patients.2patients developed recurrent bleeding in 30days after the first procedure.All patients had no severe clinical complications while 19 patients developed light maxillofacial region swell,ache,anaesthsia and gape limited.1case developed severe swell,ache of the facial skin and had to medicate after operation.Conclusion：Transcatheter embolization of the bilateral artery is an effective and safe method to treat acute intractable epistaxis.Risk can be minimized by the comprehensive angiography,normative technique and suitable embolization agents.