鼻内镜下电凝治疗顽固性鼻出血78例体会

目的探讨顽固性鼻出血常见的出血部位及治疗方法。方法回顾性分析78例顽固性鼻出血患者在鼻内镜下检查和治疗的临床资料。结果出血部位依次为：下鼻道穹隆部60．25％（47/78）、嗅裂鼻中隔部20．51％（16／78）、中鼻道后上部7．69％（6／78）和下鼻道底壁11．53％（9／78）。出血部位与年龄有一定的相关关系。49岁以下年龄组以下鼻道后方穹隆部出血最为常见，其次为下鼻道底壁，无一例发生于Woodruff静脉丛。78例中，除7例因出血汹涌先行区域性填塞待48h后电凝，其余71例均采用电凝后局部明胶海绵填塞止血。结论鼻内镜下电凝治疗顽固性鼻出血，视野清晰，止血迅速准确，方法简单有效，患者痛苦小，无并发症，无需特殊设备，值得基层医院推广应用。

A report of 78 cases of electrocoagulation therapy through nasal endoscopy for stubborn rhinorrhagia

Objective To report of 78 cases of electrocoagulation therapy through nasal endoscopy for stubborn rhinorrhagia. Methods Clinical data about 78 cases of stubborn rhinorrhagia cured through nasal endoscopy were analyzed. Results The bleed points included fornix of inferior nasal meatus 60. 25 % （47/78）, nasal septum in olfactory cleft 20. 51 %（16/78）, behind the top of middle nasal meatus 7.69 （6/78）, the bottom of inferior nasal meatus 11.53 %（9/ 78）. There were correlation between bleed points and age. Bleeding in posterior fornix of inferior nasal meatus was mostly frequent under 49 years old, followed by bottom of inferior nasal meatus. None was found in woodruff venous plexus. 71 cases were filled with gelatin sponge after electrocoagulation. Because of massive bleeding, other 7 cases were cured by regional packing firstly, then controlled of epitaxis by electroeoagulation 48 hours later. Conclusions The eleetrocoagulation therapy through nasal endoscopy is simple and effective for stubborn rhinorrhagia.