隐蔽性鼻出血常见出血部位及鼻内镜治疗策略

目的研究隐蔽性鼻出血常见出血部位以及鼻内镜下治疗策略。方法回顾性分析2012年1月—2012年12月我院门诊就诊的329例隐蔽性鼻出血的出血部位及鼻内镜下治疗方法。结果在门诊行鼻内镜检查发现明确出血点298例,经治疗后成功止血,出血部位主要位于嗅裂区、下鼻道后穹窿部及中鼻道。16例存在严重鼻中隔偏曲,1例鼻息肉,内镜均不能探及中、下鼻道或嗅裂区,入院行手术治疗后止血。14例未找到明确出血部位,于可疑出血部位填塞膨胀海绵,门诊留观未再次出血。所有患者随访1个月均无再次出血。结论隐蔽性鼻出血绝大多数可在鼻内镜下探查到明确出血点,鼻内镜下烧灼止血或常见出血部位局限性填塞有效且安全。

Analysis of Common Bleeding Parts of Concealed Epistaxis and Treatment Strategies under Nasal Endoscopy

Objective To investigate common bleeding parts of concealed epistaxis and treatment strategies under nasal endoscopy.Methods Bleeding parts and treatment strategies under nasal endoscopy in 329 patients with concealed epistaxis in the outpatient department from 2012 January to December were retrospectively analyzed.Results A total of 298 outpatients were found to have exact bleeding parts under nasal endoscopy,which were well controlled after treatment.The major common bleeding parts were olfactory cleft,posterior fornix of inferior meatus and middle meatus.Sixteen patients with severe nasal septum deviation and 1 patient with nasal polyp underwent surgical treatment for hemostasia after admission,because nasal endoscopy failed.The suspected parts of bleeding were locally packed with expansive sponges in 14 patients without certain bleeding parts,and rebleeding was not be found during observation in outpatient department.All the patients were followed up for 1 month without rebleeding.Conclusion Concealed epistaxis can be found with exact bleeding parts under endoscopy in most patients,and treatment of cauterization or local packing under the nasal endoscope is effective and safe.