[1]李 臻,余 鹏,李 鑫,等.挽救性介入治疗头颈部难治性出血[J].介入放射学杂志,2023,32(07):632-637.
 LI Zhen,YU Peng,LI Xin,et al.Salvage intervention for refractory bleeding at the head and neck region[J].journal interventional radiology,2023,32(07):632-637.
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挽救性介入治疗头颈部难治性出血()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年07
页码:
632-637
栏目:
血管介入
出版日期:
2023-07-31

文章信息/Info

Title:
Salvage intervention for refractory bleeding at the head and neck region
作者:
李 臻 余 鹏 李 鑫 李腾飞 王若愚 周朋利 叶书文 周纪妹 王 玲 谢炳灿 于 琦
Author(s):
LI Zhen YU Peng LI Xin LI Tengfei WANG Ruoyu ZHOU Pengli YE Shuwen ZHOU Jimei WANG Ling XIE Bingcan YU Qi.
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
关键词:
【关键词】 头颈部出血 肿瘤 血管畸形 介入治疗
文献标志码:
A
摘要:
【摘要】 目的 探讨急诊介入治疗头颈部难治性出血的可行性、安全性及疗效。方法 回顾性总结2016年4月至2021年4月郑州大学第一附属医院介入科收治的86例头颈部难治性出血患者临床资料,男62例、女24例,年龄12~79岁,平均(53.7±15.0)岁。患者均因保守治疗效果差而转行介入治疗。分析患者临床资料、有效止血率、临床成功止血率、住院期间再出血和离院复发原因及并发症。结果 急诊介入治疗有效止血率为96%(83/86),临床成功止血率为91%(79/86),住院期间再出血6例,离院复发12例。术后24 h内几乎所有患者均出现不同程度的口腔颌面部轻微疼痛、肿胀或皮肤色泽改变等栓塞后综合征。1例术后6 h发生右侧大面积脑梗死。随访(3~24个月)期间,7例因再发大出血而死亡,21例因肿瘤进展死亡。结论 介入治疗头颈部难治性出血疗效确切,技术安全、可行,并发症少,能挽救患者生命。

参考文献/References:

[1] 李志萍,孟 箭,吴海江,等. 超选择舌动脉栓塞在晚期舌癌大出血中的应用[J]. 中华口腔医学杂志, 2018, 53:425- 427.
[2] Kakizawa H, Toyota N, Naito A, et al. Endovascular therapy for management of oral hemorrhage in malignant head and neck tumors[J]. Cardiovasc Intervent Radiol, 2005, 28: 722- 729.
[3] Omura K. Current status of oral cancer treatment strategies: surgical treatments for oral squamous cell carcinoma[J]. Int J Clin Oncol, 2014, 19: 423- 430.
[4] Bachar G, Esmat N, Stern S, et al. Transarterial embolization for acute head and neck bleeding: eight- year experience with emphasis on rebleeding risk in cancer patients[J]. Laryngoscope, 2013, 123: 1220- 1226.
[5] Self EM,Bumpous J,Ziegler C,et al. Risk factors for hemorrhage after chemoradiation for oropharyngeal squamous cell carcinoma[J]. JAMA Otolaryngol Head Neck Surg, 2013, 139: 356- 361.
[6] 孙 伟,李 肖.头颈部肿瘤难治性出血的急诊介入栓塞治疗[J]. 中华肿瘤杂志, 2021, 43:224- 227.
[7] Han B,Li K,Wang Q,et al. Effect of anlotinib as a third- line or further treatment on overall survival of patients with advanced non- small cell lung cancer: the ALTER 0303 phase 3 randomized clinical trial[J]. JAMA Oncol, 2018, 4: 1569- 1575.
[8] 李 臻,詹鹏超,周朋利,等. 介入治疗下颌骨动静脉畸形出血的疗效分析[J]. 中华放射学杂志, 2020, 54:53- 56.
[9] 李 臻,詹鹏超,李 鑫,等. 挽救性介入治疗下颌骨动静脉畸形伴出血[J]. 介入放射学杂志, 2019, 28:1144- 1147.
[10] 纪 坤,李 臻,李 鑫,等. 载药微球化疗栓塞治疗巨大扁桃体鳞癌1例[J]. 介入放射学杂志, 2020, 29:219- 220.
[11] 许 雯,汤 玮,余少卿,等. 超选择性血管栓塞后鼻内镜下微创手术治疗鼻咽纤维血管瘤Ⅰ期的临床疗效[J]. 中国耳鼻咽喉头颈外科, 2022, 29:313- 316.
[12] Park KB,Do YS,Kim DI,et al. Endovascular treatment results and risk factors for complications of body and extremity arteriovenous malformations[J]. J Vasc Surg, 2019, 69: 1207- 1218.
[13] 牛传强, 刘珍银, 张 靖,等. 弹簧钢圈联合无水乙醇栓塞硬化治疗复杂型静脉畸形[J]. 中华放射学杂志, 2016, 50:963- 967.
[14] 陈宏宇,郭平凡,詹腾辉,等. 不同入路腔内治疗肢体动静脉畸形的临床研究[J]. 中华血管外科杂志, 2020, 5:89- 93.
[15] Nassiri N,Cirillo- Penn NC,Thomas J. Evaluation and management of congenital peripheral arteriovenous malformations[J]. J Vasc Surg,2015,62:1667- 1676.
[16] Zhao LB,Shi HB,Park S,et al. Acute bleeding in the head and neck: angiographic findings and endovascular management[J]. AJNR Am J Neuroradiol, 2014, 35: 360- 366.
[17] Suarez C,Fernandez- Alvarez V,Hamoir M,et al. Carotid blowout syndrome: modern trends in management[J]. Cancer Manag Res, 2018, 13: 5617- 5628.
[18] Chen YJ,Wang CP,Wang CC,et al. Carotid blowout in patients with head and neck cancer: associated factors and treatment outcomes[J]. Head Neck, 2015, 37: 265- 272.
[19] Patsalides A,Fraser JF,Smith MJ,et al. Endovascular treatment of carotid blowout syndrome: who and how to treat[J]. J Neurointerv Surg, 2010, 2: 87- 93.
[20] Chang FC,Luo CB,Lirng JF,et al. Endovascular management of post- irradiated carotid blowout syndrome[J]. PLoS One, 2015, 10: e0139821.
[21] Liang NL,Guedes BD,Duvvuri U,et al. Outcomes of interventions for carotid blowout syndrome in patients with head and neck cancer[J]. J Vasc Surg, 2016, 63: 1525- 1530.

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备注/Memo

备注/Memo:
(收稿日期:2022- 04- 25)
(本文编辑:茹 实)
更新日期/Last Update: 2023-07-31