资源描述：
《颅底骨折并发鼻出血诊治》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、颅底骨折并发鼻出血诊治【摘要】目的通过研究颅底骨折并鼻出血的病理解剖基础,针对不同类型鼻出血制定治疗对策。方法回顾分析近10年收治的106例颅底骨折并发鼻出血的患者，所有患者均行颅底薄层CT扫描，部分患者行脑血管造影检查。从颅底相关解剖特征、临床表现及CT扫描结果分析,研究颅底骨折鼻出血病理分类及治疗方法。结果①血性脑脊液为主的鼻出血,骨折部位多基于筛板、额窦;106例中有92例,经传统的抗菌治疗,均治愈；②严重鼻出血,骨折部位多基于颈内动脉岩内岩上段骨管周围,骨折线涉及蝶窦，106例中有10例；③严重鼻出血伴大量脑脊液漏者,为前讲述两种骨折合并存在;106例中有4例。对于后2种情况,
2、采用以鼻腔填塞止血及脑血管介入为主要措施的治疗对策,除1例颅脑损伤较重,在入院后24h内死亡,余均治愈。结论CT检查及脑血管造影对分析病情，设计治疗方案，判断预后有重要参考价值。对于颅底骨折伴严重鼻出血，脑血管造影及栓塞技术的应用为该症的治疗提供了一个较为安全可靠的方法。�【关键词】颅底骨折;鼻出血;治疗ThetreatmentofmassivenosebleedingcausedbybasalskullfractureWUXuan,CHENXi-hui,SUZhen-zhong.Departmentof9Otolaryngology,TheFirstAffiliatedHospita
3、lofSUNYat-senUniversity,Guangzhou510080,China�【Abstract】ObjectiveAfterstudyingpathologyanatomisefoundationofbasalskullfracturecombinednosebleed,setdowntreatmentcountermeasureaimedatdifferenttypesnosebleed.MethodsClinicalmaterialsof106casesofnosebleedingcausedbytraumaticbasalskullfracturewererevi
4、ewed.AllofpatientshaddonelaminaCTscanofbasalskull,partofpatientshaddoneDSA.Thepathologyclassifyandtreatmentmeasureofbasalskullfracturecombinednosebleedwereinvestigatedthroughtanalyzingbasalskullanatomisecharacter,clinicexhibitionandCTscanresult.Results①brainrapheliquidwasthemainforminthenoseblee
5、d,therewere92caseswhosethebasalskullfractureplacewasfoundonsieveplateorforehead-sinusinthe106cases,thesecasesweregiventraditionalresistbacteriumtreatment,theywereallcured.②Thosecaseswhosewasseveritynosebleed,thefracturepositionweremostlyaround9boneductofinner-carotid.Thefracturelinewererelatedto
6、sphenoidsinus,therewere10casesinallthecases.③Thecaseswhosewereseveritynosebleedcompanionmasscerebrospinalrhinorrhea,thetreatmentofthepretwotypesfractureswerethepackingofnasalcavityorchoanaeandbrainbloodvesseldigitalsubtractionangiographiclocalizationandembolization.Allthepatientshealedexceptonep
7、atientdiedin24hoursbecauseofseriousbraintrauma.ConclusionTheCTchestandbrainbloodvesseldigitalsubtractionangiographiclocalizationwereveryimportanttoanalysestate,designtreatmentplan,estimateprognosis.Theapplicationsofbrainbloo
