CAJ | 학술논문

目的探讨头颈部肿瘤术后致命性大出血的处理方法.方法对32例头颈部肿瘤术后大出血患者进行回顾性分析.结果 32例头颈部肿瘤术后大出血患者中,颈动脉出血20例,其中下咽及颈段食管癌11例,甲状腺癌3例,喉癌3例,鼻咽癌、口咽癌和腮腺癌各1例;有14例患者获得手术机会,其中13例行动脉结扎,1例患者应用碘纺压迫止血,6例获得长期生存.气管无名动脉瘘导致出血12例,其中下咽及颈段食管癌6例,甲状腺癌3例,喉癌2例,舌癌1例;有2例获得手术机会,其中1例行动脉结扎,另1例因破裂处位于主动脉弓,无法修补及结扎,无一例长期生存.结论头颈部肿瘤术后的致命性大出血是危及生命的严重并发症,早期发现和处理有助于提高抢救成功率.
목적 탐토두경부종류술후치명성대출혈적처리방법.방법 대32례두경부종류술후대출혈환자진행회고성분석.결과 32례두경부종류술후대출혈환자중,경동맥출혈20례,기중하인급경단식관암11례,갑상선암3례,후암3례,비인암、구인암화시선암각1례;유14례환자획득수술궤회,기중13례행동맥결찰,1례환자응용전방압박지혈,6례획득장기생존.기관무명동맥루도치출혈12례,기중하인급경단식관암6례,갑상선암3례,후암2례,설암1례;유2례획득수술궤회,기중1례행동맥결찰,령1례인파렬처위우주동맥궁,무법수보급결찰,무일례장기생존.결론 두경부종류술후적치명성대출혈시위급생명적엄중병발증,조기발현화처리유조우제고창구성공솔.
Objective To study the surgical management of fatal hemorrhage following head and neck surgery for cancer. Methods The clinical data of 32 cases of fatal hemorrhage following head and neck surgery from 1976 to 2008 in our department were analyzed retrospectively. Results Hemorrhage was caused by carotid blowout in 20 cases. The carotid ligation was performed in 13 cases, only 6 cases got longterm survival. In 12 cases, hemorrhage was caused by tracheo-innominate artery fistula, only 2 cases received surgical management, and no long-term survivors. Conclusion Fatal hemorrhage following head and neck surgery is an uncommon but frequently fatal complication, and the successful management of it depends on early diagnosis and correct treatment.