难治性鼻出血隐匿出血部位的分布和治疗

发布时间：2018-04-11 08:19

本文选题：鼻出血 + 内窥镜检查　；参考：《中国耳鼻咽喉头颈外科》2016年10期

【摘要】：目的通过大数据分析并绘制隐匿部位鼻出血分布"地图"以及精准优化诊疗模式。方法检索近10年鼻内镜下诊治"顽固性/难治性/隐匿性"鼻出血的中文文献117篇,患者11 708例,结合我院患者总共纳入患者11 860例,分析出血部位和责任血管,绘制成隐匿部位鼻出血分布"地图"。总结我院鼻内镜下精准搜寻出血部位、射频微创止血和无填塞的优化诊疗模式。结果我们发现责任血管主要是蝶腭动脉和筛前动脉、筛后动脉;出血部位的频率依次是下鼻道穹窿区域31.90%(3783例)、中鼻甲嗅裂区域29.70%(3522例)、中鼻道后端区域11.37%(1349例)、鼻中隔偏曲区域8.98%(1065例)、鼻腔最前上区域6.22%(738例)、其他/不明区域11.83%(1403例),将隐匿出血部位和责任血管绘制成简明的鼻出血分布"地图"。152例患者按照我院的优化诊疗模式,99.34%(151例)患者能够精准微创止血。结论我们绘制出了隐匿部位鼻出血分布"地图"以便指引出血部位的搜寻;鼻内镜下针对隐匿出血部位的精准搜寻和微创止血是优化的诊疗方案。
[Abstract]:Objective to analyze and map the distribution of occult epistaxis by big data and to optimize the diagnosis and treatment mode.Methods 117 articles of Chinese literature on the diagnosis and treatment of "intractable / refractory / occult" epistaxis under nasal endoscope in the past 10 years were retrieved. 11 708 patients were included in the study, and 11 860 patients were included in our hospital. The location of bleeding and responsible blood vessels were analyzed.Map the distribution of epistaxis in occult area.To summarize the optimized diagnosis and treatment mode of accurate search for bleeding site, radiofrequency minimally invasive hemostasis and no tamponade under nasal endoscope in our hospital.Results We found that the main responsible vessels were sphenopalatine artery, anterior ethmoidal artery and posterior ethmoidal artery.The location of concealed bleeding and responsible blood vessels were drawn into a concise map of epistaxis distribution. 152 patients were diagnosed and treated according to the optimized diagnosis and treatment mode of our hospital. 151 patients were able to stop bleeding accurately and minimally.Conclusion "map" of the distribution of occult epistaxis is drawn to guide the search of bleeding site, and the accurate search for occult bleeding site and minimally invasive hemostasis under nasal endoscope is an optimized diagnosis and treatment scheme.
【作者单位】：中山大学附属第三医院耳鼻咽喉头颈外科;中山大学中山医学院;
【基金】：广东省大学生创新训练计划项目(201601137)
【分类号】：R765.23

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