鼻内镜下低温等离子射频治疗抗凝药相关顽固性鼻出血

目的 探讨鼻内镜下低温等离子射频治疗抗凝药相关顽固性鼻出血的疗效.方法 长期服用抗凝药所致顽固性鼻出血患者49例,停用抗凝药,在鼻内镜下探明出血部位后用低温等离子射频凝固出血点.术后1周恢复抗凝药的应用,伴高血压者同期控制血压.以术后3个月内未再出现鼻出血为治愈.结果 患者的出血点均在鼻内镜下探明,鼻中隔前端21例,鼻中隔中部4例,嗅裂鼻中隔部9例,中鼻道后上部8例,下鼻道中后部出血5例,鼻底出血2例.1次治愈40例(81.6％),2次治愈9例(18.4％),总有效率100％.结论 鼻内镜下低温等离子凝固出血点具有精确微创的特点,疗效肯定,对长期服用抗凝药者影响小,是治疗抗凝药相关顽固性鼻出血的理想方法.

Treatment of anticoagulant related refractory epistaxis by coblation technique under endoscope

Objective To investigate the effect of radiofrequency treatment on coagulation drug related re- fraetory epistaxis under endoscope. Methods Forty-nine cases of refractory epistaxis patients were treated with ra- diofrequency technique under endoscope after determining the bleeding position. At the same time anticoagulant drugs were stopped for one week and high blood pressure patients were treated to control the blood pressure. These patients were observed for 3 months. Results All the bleeding position of these patients were determined under en- doscope. Of all the bleeding position, 21 eases were in the anterior area of nasal septem, 4 cases were in the middle area of nasal septem, 9 cases were in the nasal septem area of the olfactory fisser, 8 cases were in the superior and posterior area of middle meatus, 5 cases were in the middle and posterior area of middle meatus, 2 cases were in the nasal base. Forty eases （81.6%） cured for one time, 9 cases （ 18.4% ） cured for two times, the total effective rate was 100%. Conclusions Endoscopic radiofrequeney technique is an ideal method for treating refractory anticoagu- lant related epistaxis. It is accurate, minimally invasive and can get perfect results.