山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (5): 92-95.doi: 10.6040/j.issn.1673-3770.0.2018.366

• 论著 • 上一篇    下一篇

鼻内镜下蝶腭动脉阻断术治疗老年难治性鼻出血

李强1(),刘志元1,周涵2   

  1. 1. 沭阳县人民医院耳鼻咽喉科，江苏 沐阳 223600
    2. 南京医科大学第一附属医院 江苏省人民医院耳鼻咽喉科，江苏 南京 210029
  • 收稿日期:2018-08-11 修回日期:2018-10-09 出版日期:2019-09-20 发布日期:2019-10-15
  • 通讯作者: 李强 E-mail:893098@qq.com

Clinical analysis of endoscopic ligation of the sphenopalatine artery in elderly patients with intractable epistaxis

Qiang LI1(),Zhiyuan LIU1,Han ZHOU2   

  1. 1. Department of Otorhinolaryngology, Shuyang People′s Hospital, Suqian 223600，Jiangsu，China
    2. Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University & Jiangsu Province Hospital, Nanjing 210029，Jiangsu，China
  • Received:2018-08-11 Revised:2018-10-09 Online:2019-09-20 Published:2019-10-15
  • Contact: Qiang LI E-mail:893098@qq.com

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摘要： 目的

探讨鼻内镜下蝶腭动脉阻断术治疗老年难治性鼻出血的疗效。

方法

选择41例年龄在60岁以上的老年难治性鼻出血患者为研究对象，随机分成治疗组(21例, 行鼻内镜下蝶腭动脉阻断术)和对照组(20例，鼻内镜下行膨胀海绵填塞)，出院后均随访6个月，记录鼻出血有无复发、术后疼痛、 满意度、住院天数及并发症等情况。

 结果

治疗组一次性治疗痊愈率为81.0%，明显高于对照组（50.0%），且两组疗效差异有统计学意义（P<0.05）。治疗组平均住院天数为6.5 d，明显短于对照组的10.7 d，且治疗组患者术后疼痛明显轻于对照组，并对住院期间诊疗效果更满意（P均<0.001）。患者均无严重并发症发生。

 结论

鼻内镜下蝶腭动脉阻断术治疗老年难治性鼻出血疗效可靠，能缩短住院时间，术后疼痛轻且并发症发生率低，可作为首选治疗方案。

关键词: 鼻出血, 蝶腭动脉, 鼻内镜外科手术, 老年人

Abstract: Objective

To investigate the efficacy of endoscopic ligation of the sphenopalatine artery in elderly patients with intractable epistaxis.

Methods

The study included 41 elderly patients with intractable epistaxis. All patients were randomly assigned to two groups, namely, the treatment group (21 patients undergoing an endoscopic ligation of the sphenopalatine artery) and the control group (20 patients undergoing an endoscopic nasal packing). During the hospitalization and the 6-month follow-up, the epistaxis relapse rate, the postoperative pain, a satisfaction survey, the length of the hospital stay, and complications were evaluated.

 Results

A significantly higher cure rate was obtained in the treatment group compared with the control group (81.0% vs. 50%, P<0.05). The average hospitalization duration of the treatment group was significantly shorter than that of the control group (6.5 days vs. 10.7 days, P<0.05). The treatment group was remarkably superior to the control group in both the degree of postoperative pain and satisfaction (both P<0.001). No severe complications were observed in any patient.

 Conclusion

For elderly patients with intractable epistaxis, endoscopic ligation of the sphenopalatine artery should be considered as a first-line treatment due to its advantages such as fast and effective action, short hospital stay, little postoperative pain, and few complications.

Key words: Epistaxis, Sphenopalatine artery, Nasal endoscopic surgical procedures, operative, Aged

中图分类号: 

  • R765.23

表1

两组病例一般情况比较（例）"

分组 性别 年龄(岁) 病程（d）
男 女 60～70 71～80 >80岁 1～7 7～14 >14
治疗组 14 7 9 9 3 14 5 2
对照组 12 8 9 8 3 12 7 1

表2

两组病例疗效、住院天数和疼痛评分比较"

组别 疗效（n） 住院天数（d， x ˉ ± s ）

疼痛评分

（VAS评分， x ˉ ± s ）
痊愈 显效 无效
治疗组 17 3 1 6.5±1.34 4.4±2.03
对照组 10 6 4 10.7±2.60 7.9±1.87
U/t 142.0 -16.67 -2.33
P 0.034 <0.001 <0.001

图1

两组病例满意度调查情况"

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