Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (5): 92-95.doi: 10.6040/j.issn.1673-3770.0.2018.366

• Original Article • Previous Articles     Next Articles

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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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

CLC Number: 

  • R765.23

Table 1

Characteristics of participants in the two groups（n）"

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

Table 2

Comparison of efficacy, hospital stay and pain score of the two groups"

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

Fig.1

Satisfaction survey of the two groups"

1 Nouraei SA , Maani T , Hajioff D , et al . Outcome of endoscopic sphenopalatine artery occlusion for intractable epistaxis: a 10-year experience[J]. Laryngoscope, 2007, 117(8): 1452-1456. doi:10.1097/MLG.0b013e31806-5b86f .
doi: 10.1097/MLG.0b013e31806-5b86f
2 周义德, 郑宏良, 沈小华, 等 . 伴高血压的鼻部阻塞性疾病患者术后血压观察[J]. 山东大学耳鼻喉眼学报, 2006, 20(4): 317-318,321. doi:10.3969/j.issn.1673-3770.2006.04.009 .
doi: 10.3969/j.issn.1673-3770. 2006.04.009
ZHOU Yide , ZHENG Hongliang , SHEN Xiaohua , et al . Blood pressure changes in patients with nasal obstruction accompanied by persistent hypertension after nasal endoscopic surgery[J]. J Otolaryngol Ophthalmol Shandong Univ, 2006, 20(4): 317-318,321. doi:10.3969/j.issn.1673-3770. 2006.04.009 .
doi: 10.3969/j.issn.1673-3770. 2006.04.009
3 Umapathy N , Quadri A , Skinner DW . Persistent epistaxis: what is the best practice?[J]. Rhinology, 2005, 43(4): 305-308.
4 Lin G , Bleier B . Surgical management of severe epistaxis[J]. Otolaryngol Clin North Am, 2016, 49(3): 627-637. doi:10.1016/j.otc.2016.01.003 .
doi: 10.1016/j.otc.2016.01.003
5 de Bonnecaze G , Gallois Y , Bonneville F , et al . Transnasal endoscopic sphenopalatine artery ligation compared with embolization for intractable epistaxis: a Long-term analysis[J]. Am J Rhinol Allergy, 2018, 32(3): 188-193. doi:10.1177/1945892418768584 .
doi: 10.1177/1945892418768584
6 倪凌达, 张玉君, 朱华明, 等 . 鼻内镜下蝶腭动脉电凝术治疗严重后段鼻出血[J]. 山东大学耳鼻喉眼学报, 2012, 26(1): 35-37.
NI Lingda , ZHANG Yujun , ZHU Huaming , et al . Endoscopic ligation of the sphenopalatine artery in posterior epistaxis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2012, 26(1): 35-37.
7 张维天, 王磊, 于栋祯, 等 . 鼻内镜下蝶腭动脉电凝术治疗顽固性鼻出血[J]. 临床耳鼻咽喉头颈外科杂志, 2009, 23(8): 343-345. doi:10.3969/j.issn.1001-1781.2009.08.003 .
doi: 10.3969/j.issn.1001-1781.2009.08.003
ZHANG Weitian , WANG Lei , YU Dongzhen , et al . Endoscopic diathermy of the sphenopalatine artery as the primary management for refractory epistaxis[J]. J Clin Otorhinolaryngol Head Neck Surg, 2009, 23(8): 343-345. doi:10.3969/j.issn.1001-1781.2009.08.003 .
doi: 10.3969/j.issn.1001-1781.2009.08.003
8 张满峰, 于娜 . 顽固性鼻出血68例临床分析[J]. 临床耳鼻咽喉科杂志, 2004, 18(9): 569-570. doi:10.3969/j.issn.1001-1781.2004.09.026 .
doi: 10.3969/j.issn.1001-1781.2004.09.026
9 Eladl HM , Elmorsy SM , Khafagy YW . Endoscopic devascularisation of sphenopalatine bundle in intractable posterior epistaxis: technique, efficacy and safety[J]. J Laryngol Otol, 2011, 125(11): 1136-1140. doi:10.1017/S0022215111002180 .
doi: 10.1017/S0022215111002180
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