鼻内镜治疗难治性鼻出血的疗效分析

发布时间：2017-12-28 00:27

本文关键词：鼻内镜治疗难治性鼻出血的疗效分析　出处：《东南国防医药》2016年05期 　论文类型：期刊论文

【摘要】：目的分析鼻内镜治疗难治性鼻出血的疗效,与传统的填塞止血方法比较。方法回顾性分析2013年1月-2014年12月接受治疗的鼻出血患者79例的临床资料。比较鼻内镜止血组(61例)与鼻腔填塞止血组(18例)的治疗效果、疼痛程度、再出血(治疗后至随访4周结束)、出血量(治疗开始至随访4周结束)、术后鼻腔恢复通气时间等。结果鼻内镜组患者治愈率为91.8%,高于鼻腔填塞组(72.2%)。术后4周内鼻内镜组患者再出血率为6.5%,低于鼻腔填塞组38.9%。治疗中鼻内镜组患者疼痛评分平均值为(3.11±2.72),与鼻腔填塞组(3.74±1.49)比较,差异无统计学意义(P0.05),治疗后疼痛评分平均值(1.59±0.48)低于鼻腔填塞组(3.43±1.37)。鼻内镜组总出血量(31.05±12.83)m L低于鼻腔内填塞组(51.09±18.32)m L。鼻内镜组术后主观鼻腔恢复通气时间(3.1±1.8)d短于鼻腔填塞组(6.4±1.8)d。以上各项指标两组比较,除治疗中患者疼痛评分平均值外,其他指标差异均有有统计学意义(P0.01)。结论鼻内镜下电凝止血术操作出血点位置准确,疗效可靠,出血量少,疼痛较轻,术后恢复较快,可作为难治性鼻出血的首选治疗方法。
[Abstract]:Objective to analyze the curative effect of endoscopic nasal endoscopic treatment for intractable epistaxis and compare with traditional methods of filling hemostasis. Methods the clinical data of 79 patients with nasal bleeding treated in December -2014 January 2013 were analyzed retrospectively. The therapeutic effect, pain degree, rebleeding (after treatment to the end of 4 weeks), bleeding volume (the beginning of treatment to the end of 4 weeks) and the time of nasal ventilation after operation were compared between 61 patients with nasal endoscopy and 18 patients with nasal packing. Results the cure rate of the patients in the nasal endoscopy group was 91.8%, which was higher than that of the nasal cavity filling group (72.2%). The rebleeding rate of the patients in the endoscopic group was 6.5% within 4 weeks after the operation, which was lower than that of the nasal packing group (38.9%). The average score of pain in the treatment group was (3.11 + 2.72), which was not significantly different from that in the nasal packing group (3.74 + 1.49) (P0.05). The average score of pain score after treatment was (1.59 + 0.48) lower than that in the nasal packing group (3.43 + 1.37). The total amount of bleeding (31.05 + 12.83) m L in the nasal endoscopy group was lower than that in the nasal packing group (51.09 + 18.32) m L. The duration of the subjective nasal cavity recovery (3.1 + 1.8) d was shorter than that of the nasal packing group (6.4 + 1.8) d after the endoscopic sinus surgery. The two groups of the above indexes, except the average value of pain score in the treatment of the patients, the difference of other indexes had statistical significance (P0.01). Conclusion endoscopic hemostasis is accurate and reliable, with less bleeding, less pain and faster postoperative recovery. It can be used as the first choice for intractable epistaxis.
【作者单位】：南京军区南京总医院汤山疗养院耳鼻咽喉-头颈外科;南京军区南京总医院耳鼻咽喉-头颈外科;
【分类号】：R765.23
【正文快照】： 鼻出血(epistaxis)是耳鼻喉科常见的症状,可由鼻部本身的疾病引起,如鼻中隔偏曲、内翻性乳头状瘤[1]、鼻腔恶性肿瘤,也可继发于全身性疾病[2]。一般鼻出血为单侧。出血量多少不一,轻者仅呈现为涕中带血,严重者可引起失血性休克,可表现为间歇性出血,也可为持续性出血。反复鼻出

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