CAJ | 학술논문

目的探讨颅底骨折致口鼻大出血的救治策略.方法回顾分析14例严重颅底骨折伴口鼻大出血患者,入院即行气管切开或气管插管,保证呼吸道通畅,抗休克同时送入介入室行颈动脉造影,找到出血血管,然后通过介入栓塞手段行血管内栓塞止血.结果全组14例患者口鼻腔出血经栓塞后均及时成功止血,未出现栓塞后并发症.恢复良好10例,重残3例,死亡1例.重残及死亡均与脑外伤有关.结论保持呼吸道通畅、维持有效血压后紧急行血管内介入栓塞止血能有效提高颅底骨折致口鼻大出血休克的抢救成功率,特别为合并脑创伤患者的成功抢救提供了保证.
목적 탐토로저골절치구비대출혈적구치책략.방법 회고분석14례엄중로저골절반구비대출혈환자,입원즉행기관절개혹기관삽관,보증호흡도통창,항휴극동시송입개입실행경동맥조영,조도출혈혈관,연후통과개입전새수단행혈관내전새지혈.결과 전조14례환자구비강출혈경전새후균급시성공지혈,미출현전새후병발증.회복량호10례,중잔3례,사망1례.중잔급사망균여뇌외상유관.결론 보지호흡도통창、유지유효혈압후긴급행혈관내개입전새지혈능유효제고로저골절치구비대출혈휴극적창구성공솔,특별위합병뇌창상환자적성공창구제공료보증.
Objective To explore the treatment strategy for mouth and nose bleeding caused by skull base fractures. Methods A retrospective analysis was done on 14 patients with severe skull base fracture combined with nose and mouth bleeding admitted to hospital. Tracheotomy or tracheal intubation was performed to ensure airway patency. When anti-shock was performed, the patients were sent for carotid artery angiography to identify the blood vessel. Then, hemostasis was done by means of direct intravascular interventional embolization. Results Timely and successful hemostasis was achieved in all 14 patients after embolization, with no complications occurred. Of all patients, there were 10 patients with good recovery, three with disability and one death. Severe disability and death were related to brain injury. Conclusions After maintenance of airway patency and effective blood pressure, emergency endovascular embolization can effectively improve the rate of successful treatment of nose and mouth bleeding caused by traumatic skull base fractures, especially for patients combined with traumatic brain injury.