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上颌动脉及/或筛前动脉结扎后仍持续或反复发作的严重鼻衄,究其原因,一是解剖方面的,即上颌动脉在翼腭窝的变异很大,鼻后动脉和蝶腭动脉在翼颌缝处很少分叉,两者都需结扎;鼻后动脉与筛动脉之间有吻合支,单纯结扎上颌动脉后,使颈内动脉血流通过这一吻合支发生改道;颈内和颈外动脉通过翼管动脉发生吻合。另一则可能是全身性中小型血管病变因素,如动脉粥样硬化或某些未曾查知的结缔组织病变等。通过两例报道说明筛后动脉是这类鼻衄的一个重要来源:例1是79岁男性高血压、冠脉病及慢性阻塞性肺疾患者,先后行右上颌动脉及筛前动脉结扎、中隔粘膜下切除及内窥镜下鼻内电烙术,仍反复鼻腔后上份出
The reason why the maxillary and / or anterovenous arteries continue or recurrent severe epistaxis is anatomical, that is, the variation of the maxillary artery in the pterygopalatine fossa is very large. The posterior nasal artery and sphenopalatine artery in the Wing splint seldom bifurcated, both to be ligation; anastomosis between the posterior nasal artery and screen artery branch, simply ligation of the maxillary artery, the internal carotid artery blood flow through this anastomosis branch diversion; intracranial and External carotid artery anastomosis through the artery. The other may be systemic small and medium-sized vascular disease factors, such as atherosclerosis or some unknown connective tissue lesions. After two cases reported by the posterization of the arteries is an important source of such epistaxis: Example 1 is a 79-year-old man with hypertension, coronary artery disease and chronic obstructive pulmonary disease patients, followed by the right maxillary artery and anterior ethmoid ligation, Subsequent mucosal resection and endoscopic intranasal electrocautery, nasal cavity is still repeated after the copy