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目的 探讨经导管动脉栓塞治疗难治性及威胁生命的鼻出血的疗效及并发症的防治策略.资料与方法 回顾性分析2001至2008年期间59例难治性及威胁生命的鼻出血患者资料,经常规后鼻腔填塞、药物治疗等措施无效后,在DSA下明确出血靶动脉后选择适当栓塞材料栓塞出血靶动脉,随访1～30天,观察栓塞疗效及并发症情况.结果 59例鼻出血患者除1例因主动脉及左颈总动脉非常迂曲,导管无法进入,未行栓塞;1例因失血性休克在造影中死亡而未行栓塞;1例颈内动脉段巨大假性动脉瘤结合外科手术外;余56例均成功完成血管内栓塞治疗,技术成功率为94.9%(56/59),37例栓塞后活动性出血停止,18例栓塞术后1周内仍有少量出血,后结合内科治疗,出血停止,栓塞有效率98.2%(55/56),1例栓塞后1个月再次出血,第二次栓塞后随访1个月未复发.29例栓塞后无并发症出现,23例术后出现头痛,低热,颌面部麻木、张口受限等轻度并发症,1例术后头痛剧烈、头面部数处表皮坏死,3例术后出现脑栓塞导致相应肢体偏瘫.结论 对于难治性及威胁生命鼻出血,血管内栓塞目前已成为有效而安全的治疗方法.栓塞后可能出现栓塞后综合征及局部缺血症状,严重者可有局部坏死出现,最严重者可有颈内系统的误栓,导致脑栓塞.因此根据原发病因制定适当治疗方案、术中超选择插管、合理选择栓塞剂及栓塞方法是减少并发症的关键.“,”Objective To evaluate the complications and efficacy of arteria embolisation in the management of intractable and life threatening epistaxis. Materials and Methods From December 2001 to July 2008, fifty nine patients of intractable and life-threatening epistaxis,who had been treated with nasal cavity packing and medicine but failed underwent angiography and embolization treatment. 1 to 30 days later, complications were observed to evaluate the therapeutic efficacy of arteria embolisation. Follow-up 1 to 30 days to observe the complications and therapeutic of arteria embolisation. Resuits 56 (56/59) patients were successfully embolized with successful rate of 94.9%. 1 patient had tortuous arteriae aorta and left common carotid so that could not be embolized. 1 patients died of the hemorrhagic shock during angiography and 1 patient performed operation because of the large pseudoaneurysm in the internal carotid cavernous. Bleeding was completely controlled in 37 patients. 18 patients developed recurrent epistaxis one week after the medical treatment. One required re-embolisation 1 month after the first procedure. 29 patients had no obvious complications oceured while 23 patients developed light headache,low-grade fever, maxillofacial region anaesth and gape limited. One case developed necrosis of the facial skin and severe headache after embolization. The other 3 patients resulted in hemiplegic paralysis because of cerebral embolism after embolization. Conclusion Endovascular embolisation is an effective method in the management of intractable and life-threatening epistaxis. It may appear post embolization syndrome or ischemia after embolisation. It may also lead to local necrosis if endured severe distal embolization. Dangerously it may induce to cerebral embolism. Risk can be minimized by the proper therapeutic option according to the primary disease, technique of superseleetive embolization, suitable embolization agent and methods.