内镜下治疗顽固性鼻出血87例的临床研究

目的探讨经鼻内窥镜下治疗顽固性鼻腔出血的优越性和实用性。方法对87例顽固性鼻出血患者,全部在表麻下经鼻窦内窥镜直视下找到出血点,通过高频电凝或MEROCEL止血海绵填塞等手段完成止血治疗。结果位于鼻底、后鼻孔出血16例,占18.39%;中鼻道后上部出血43例,占49.43%;中鼻甲对应的鼻中隔中、上部出血23例,占26.44%;鼻腔广泛出血,无法找到明确出血部位5例,占5.74%。中鼻甲对应的鼻中隔中上部及鼻腔广泛出血的用MEROCEL止血海绵填塞压迫止血,其余病例用高频电凝止血。全部病例1次治愈72例占82.76%;第2次治愈13例,占14.94%;第3次治疗失败2例,改行血管造影动脉栓塞后治愈,占2.3%。全部病例随访3个月以上均无复发。结论鼻腔深部的顽固性鼻出血,临床上传统的治疗方法要达到有效的止血目的仍很困难。而鼻内镜直视下通过高频电凝或止血海绵填塞等手段完成的止血治疗,方法简单、止血效果好,明显减轻病人的痛苦,是一种实用及有效的止血方法。

The Clinical Research of 87 Cases Treating for Obstinate Epistaxis Under the Endoscope

Objective TO Probe into uperiority and practicabilitythat treating the obstinate nasal cavitybleeds from the sinuscope.Methods 87 obstinate epistaxis patients is to find to bleed focus through The high-frequency electricity congealing and arrest blood or with means Such as MEROCEL styptic sponge is clogged finisharresting blood to treat under the light shines vision by sinuscope with all surface anaesthetizing .Resultsbleed lie by nose bottom and posterior nares has 16 cases, accounts for 18.39%; middle meatus and then the topbleed has 43 cases, account for 49.43%; middle turbinate corresponding the middle and the top nasal septum bleedhas 23, account for 26.44%; The nasal cavity bleeds extensively, unable to find position of bleeding clearly has5 cases , accounts for 5.74%. All cases once are cured 72 and account for 82.76% ; All use the styptic spongeinstead to clog for the 2nd time, 13 cases are cured , account for 14.94%; 2 cases is fail to treat , changeone's profession angiography artery cure after the embolism to arrest blood to clog for the 3rd time, accountsfor 2.3%. All cases follow up a case by regular visits to 3 months ,and none to find recur.Conclusions To Nasalcavity depths obstinate epistaxis ,It is still very difficult that the traditional treatment method should achieveeffective styptic purpose on clinic ,and under the direct-view by sinuscope through The high-frequencyelectricity congealing and arrest blood or with means Such as styptic sponge is clogged to finish arresting bloodto treat , this method is simple, arrest blood effectually, it is a kind of feasible styptic method to obviouslylighten the patient's agony.