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目的 :了解选择性血管内栓塞治疗难治性鼻出血的疗效及影响疗效的因素。方法 :2 3例难治性鼻出血患者在颈动脉数字减影血管造影 (DSA)的基础上行选择性颌内动脉末梢病变血管内栓塞 ,其中 5例同时栓塞面动脉。结果 :DSA证实 2 3例患者均存在颌内动脉末梢发育不良或畸形 ,15例伴有出血征象 ,6例并面动脉形态异常。治愈 2 2例 ,其中 1例 2 4h内复发鼻出血者证实有新侧支供血 ,经补加栓塞后出血停止 ,治愈率为95 .6 %。 1例治疗失败 ,与栓塞前去除鼻腔填塞物有关 ,且不能除外有面动脉出血。结论 :难治性鼻出血与颌内动脉发育不良及畸形有关 ,选择性血管内栓塞治疗能收到迅速而满意的疗效。治疗失败与潜在侧支开放或面动脉出血有关 ,过早去除鼻腔填塞物也是影响栓塞疗效的因素
Objective: To understand the curative effect of selective endovascular embolization on intractable epistaxis and the factors influencing curative effect. Methods: Twenty-three patients with intractable epistaxis underwent endovascular embolization of selective maxillofacial peripheral lesions on the basis of digital subtraction angiography (DSA) of the carotid artery. Among them, 5 patients underwent embolization of the arterial surface. Results: DSA confirmed the presence of dysplasia or deformity of the maxillary internal mammary artery in all 23 patients, 15 with bleeding signs and 6 with abnormal facial morphology. 22 cases were cured, of which 1 case within 24 hours of recurrent nasal hemorrhage confirmed a new lateral supply of blood, stop bleeding after additional embolization, the cure rate was 95.6%. One case failed treatment, with the removal of nasal packing before embolization, and can not be excluded except for articular bleeding. Conclusion: Refractory nasal hemorrhage is related to poor development of mandibular arteries and deformity. Selective endovascular embolization can receive prompt and satisfactory curative effect. Failure to treat is associated with potential collateral openness or facial artery bleeding, and premature removal of nasal packing is also a factor that affects the efficacy of embolization