鼻内镜下治疗难治性鼻出血的临床研究

发布时间：2018-06-19 10:56

本文选题：难治性鼻出血 + 定位　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:分析在鼻内镜设备下电凝结合局部鼻腔填塞治疗难治性鼻出血的利弊,评估其疗效,总结难治性鼻出血在临床上常见的出血部位。方法:选取60例自2015年12月至2017年2月期间收治于新疆医科大学第四附属医院耳鼻咽喉科的难治性鼻出血病例,在鼻内镜下寻找明确出血点,对其电凝治疗,部分病例据情况予以紫草油纱条术后局部填塞治疗,22例传统鼻腔填塞治疗的难治性鼻出血病例与上述60例比较得出患者临床有效率、疼痛程度、术后并发症、治疗过程中出血量及术后鼻腔恢复情况的结果。结果:两组82例患者中1次治愈74例,2次治愈79例,需经过3次治疗的仅4例,其中鼻内镜止血组60例病人总有效率100%。出血部位在下鼻道(多位于穹隆部)36例(43.90%)、鼻中隔中后部25例(30.49%)、中鼻道11例(13.41%)、鼻中隔前上部6例(7.32%)、嗅裂及蝶筛隐窝4例(4.88%),且以老年人为多数。结论:将鼻内镜技术熟练运用在难治性鼻出血的治疗上疗效显著,鼻内镜具有视野明亮开阔、微创、定位准确、并发症少等优点,符合微创外科的观念。
[Abstract]:Objective: to analyze the advantages and disadvantages of electrocoagulation combined with local nasal packing in the treatment of intractable epistaxis, to evaluate the curative effect and to summarize the common bleeding sites in clinic. Methods: from December 2015 to February 2017, 60 cases of refractory epistaxis in the Department of Otorhinolaryngology, fourth affiliated Hospital of Xinjiang Medical University were selected. According to the situation, 22 cases of refractory epistaxis treated by traditional nasal packing were treated with local tamponade after the operation of purple oil gauze. Compared with the 60 cases mentioned above, the clinical effective rate, degree of pain, postoperative complications were obtained. Results of bleeding volume and recovery of nasal cavity after treatment. Results: of the 82 patients in the two groups, 74 cases were cured once and 79 cases were cured twice, only 4 cases needed 3 times treatment. The total effective rate was 100% in 60 cases of nasal endoscopy hemostasis group. The location of bleeding was in the inferior nasal canal (36 cases were located in the fornix, 25 cases were located in the middle and posterior part of the nasal septum), 11 cases were located in the middle nasal canal (13.41%), 6 cases in the upper part of the nasal septum, 4 cases in the olfactory fissure, 4 cases in the sphenoethmoid recess, and 4 cases in the elderly. Conclusion: the application of endoscopic technique in the treatment of intractable epistaxis is effective. Nasal endoscopy has the advantages of bright and open field of vision, minimally invasive, accurate positioning and less complications, which is in line with the concept of minimally invasive surgery.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R765.9

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