鼻咽癌放疗后大出血的诊治

Management of massive epistaxis after radiotherapy of nasopharyngeal carcinoma

摘要:

目的探讨鼻咽癌放疗后大出血的诊治方法及治疗结果。方法收集2011年1月~2015年12月诊治的7例鼻咽癌放疗后大出血患者，分析其临床特点、各种诊治方法的特点及疗效。结果7例鼻咽癌放疗后大出血患者，治愈出院2例，转院行颈内动脉栓塞1例，已治愈。住院期间死亡3例，1例自动出院后死亡。结论鼻咽癌放疗后大出血积极的检查明确出血原因及部位，针对出血原因及部位可采取治疗措施，包括预防性气管切开，不得已情况下的长时间填塞及颈内动脉栓塞，能够有效降低鼻咽癌放疗后鼻出血的死亡率。

关键词:鼻出血|鼻咽癌|放疗

Abstract:

ObjectiveTo study the clinical management of massive epistaxis after radiotherapy of nasopharyngeal carcinoma (NPC) and evaluate the therapeutic outcome.MethodsClinical data of 7 NPC patients with massive epistaxis after radiotherapy admitted to our department from Jan 2011 to Dec 2015 were analyzed retrospectively. The clinical characteristics of the massive epistaxis, the features and effects of its various management methods were summarized.Results Of all the 7 cases, 2 were cured in our department, one was transferred and cured with embolization of internal carotid artery, 3 cases died during inhospital period, and one died after voluntary discharge.ConclusionsFor massive epistaxis after radiotherapy of NPC, aggressive investigations should be performed to determine the cause and site, and to adopt proper management strategy. Treatments including preventive tracheotomy, longterm nasal packing and embolization of internal carotid artery by some unavoidable circumstances can effectively decrease the mortality of massive epistaxis after radiotherapy of NPC.

Key words:Epistaxis|Nasopharyngeal Neoplasm| Radiotherapy