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スフェノパラチン動脈結合の成功に影響を与える要因 引き出せぬエピスタクシー-A単一中心の遡及分析
Joseph Latif1, Emma Ho1, Jordan Fuzi1
1Department of Otolaryngology, Head & Neck Surgery, Prince of Wales Hospital, Sydney, NSW, Australia.
American journal of rhinology & allergy
|August 29, 2025
まとめ
重度の鼻出血に対する内視動脈結束 (ESPAL) は有効ですが,喫煙者,抗凝固剤を服用している人,または悪性腫瘍の患者では再発が一般的です. 再発はしばしばさらなる放射線介入を必要とします.
科学分野:
- 耳鼻喉科
- 侵襲 的 な 手術
- 介入放射線学
背景:
- 吸い取れないエピスタキスの管理には,しばしば外科的介入が必要です.
- エンドスコピック・スフェノパラチン動脈連動 (ESPAL) は重度の鼻出血の治療法として認められています.
- ESPALの成功/失敗に影響を与える要因は,まだ十分に定義されていない.
研究 の 目的:
- ESPALの有効性に影響を与える患者,疾患,外科的要因を特定する.
- ESPAL後のエピスタキスの再発予測要因を分析する.
- 治療不可能なエピスタキスのESPALの結果を評価する.
主な方法:
- 14年にわたる40のESPAL手順の遡及分析
- 術後同じ側で出血が再発すると定義される.
- 患者を非再発と再発のコホートに分けました
主要な成果:
- 5年以内に20パーセントのエピスタキスが再発することが観察されました.
- 抗凝固薬,喫煙,活発な悪性腫瘍による再発リスクの有意な増加 (P < .05).
- ESPALの平均10日後に再発したエピスタキスは,しばしば血管内栓塞が必要でした.
結論:
- ESPALの後,約20%の患者が再発する.
- 喫煙者,抗凝固薬を受けている患者,悪性腫瘍患者では再発率が高くなります.
- ESPAL後の再発はしばしば放射線学的介入を必要とするが,それは効果的であることが証明された.
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