山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (4): 4-5.doi: 10.6040/j.issn.1673-3770.0.2013.159

• 鼻内镜下治疗难治性鼻出血 • 上一篇    下一篇

鼻内镜治疗难治性鼻出血121例疗效分析

余鹏举1,许风雷2,江满杰2   

  1. 1.江苏省昆山市中医医院耳鼻咽喉科, 江苏 昆山 215300; 
    2.南京军区南京总医院耳鼻咽喉-头颈外科, 南京 210002
  • 收稿日期:2013-05-25 发布日期:2013-08-16
  • 作者简介:余鹏举。 Email:ypj1025@163.com

Electric coagulation hemostasis under nasal endoscopy for 121 cases of intractable nosebleed

YU Peng-ju1, XU Feng-lei2, JIANG Man-jie2   

  1. 1. Department of Otolaryngology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan  215300, Jiangsu, China; 2. Department of Otolaryngology, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002,China
  • Received:2013-05-25 Published:2013-08-16

摘要:

目的   分析难治性鼻出血的鼻内镜治疗效果,并与传统的填塞止血方法进行比较。方法   回顾分析2011年1月至2012年12月接受治疗的鼻出血患者的临床资料。比较鼻内镜下止血组与鼻腔内填塞止血组患者的治疗效果、疼痛程度、术后并发症、再出血(治疗后至随访2个月结束)、出血量(治疗开始至随访2个月结束)、术后鼻腔恢复通气时间、鼻黏膜恢复时间等。结果   鼻内镜组治愈率高于鼻腔内填塞组,差异有统计学意义(97.2%,69/71 vs 84.0%,42/50;P=0.0095);术后2个月内鼻内镜组再出血率低于鼻腔内填塞组,差异有统计学意义(5.6%,4/71 vs  46.0%,23/50;P<0.001);治疗中及治疗后鼻内镜组疼痛评分平均值均低于鼻腔内填塞组,差异均有统计学意义(3.08±0.72 vs 4.72±0.49; P<0.001; 2.59±0.48 vs 4.21±0.58; P<0.001);鼻内镜组患者术后并发症发生率低于鼻腔内填塞组,差异有统计学意义(21.1%,15/71 vs 42.0%,21/50; P=0.0134);鼻内镜组总出血量低于鼻腔内填塞组,差异有统计学意义[(35.75±9.83) mL vs (64.89±14.32)mL, P<0.001];鼻内镜组术后恢复通气时间短于鼻腔内填塞组,差异有统计学意义[(3.34±0.87)d vs (7.14±2.31)d, P<0.001];鼻内镜组患者术后鼻黏膜恢复时间早于鼻腔内填塞组,差异有统计学意义[(5.68±3.21)d vs (9.31±3.76)d;P<0.001)。结论   鼻内镜下电凝止血术疗效可靠,并发症少,术后恢复较快,可作为难治性鼻出血的首选治疗方法。

关键词: 鼻内镜检查, 并发症, 疼痛, 填塞止血, 难治性鼻出血

Abstract:

Objective    To study the clinical effect of electric coagulation hemostasis under nasal endoscopy for treatment of intractable nosebleed. Methods    Clinical data of intractable nosebleed patients received treatment at our hospital from 2011 to 2012 were retrospectively analyzed. Patients were divided into two groups. Group A received nasal endoscopic treatment and group B received packing hemostasis treatment. Cure rate, complications, pain scale, recovery and rehaemorrhagia rate were compared between the two groups. Results    Group A had a higher cure rate than group B(97.2%, 69/71 vs 84.0%, 42/50; P=0.0095).The pain scales were lower in group A both peri-treatment and post-treatment than in group B (3.08±0.72 vs 4.72±0.49; P<0.001; 2.59±0.48 vs 4.21±0.58; P<0.001). The group A patients had a sooner recovery than group B patients (P<0.001). Group A patients had a lower rehaemorrhagia rate than group B patients(5.6%, 4/71 vs  46.0%, 23/50; P<0.001). Conclusion    Electric coagulation hemostasis under nasal endoscopy is a safe and effective treatment for intractable nosebleed.

Key words: Nasal endoscopy, Complications; Pain, Packing hemostasis, Intractable nosebleed

中图分类号: 

  • R765.23
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