106例顽固性鼻出血各种治疗方法临床分析

目的 探讨顽固性鼻出血的常见出血部位与治疗效果。方法 106例患者中,93例鼻内镜下微波、双极电凝点灼治疗,13例行数字减影血管造影（DSA）,其中12例DSA后超选择颌内动脉或面动脉明胶海绵栓塞,8例鼻出血停止期行鼻中隔偏曲矫正术。结果 后鼻孔外侧、下鼻道、蝶腭动脉孔区、鼻中隔后上部、筛泡附近是鼻出血好发部位,通过使用微波、双极电凝控制出血占87.7%（93/106）。结论 鼻内镜下的微波、双极电凝治疗能作为首选,不成功患者选用DSA及动脉栓塞可获得治愈。

Intractable epistaxis clinic analysis of 106 cases of different therapeutic methods

Objective To discuss frequently bleeding areas of intractable epistaxis and therapeutic effect.Methods Among all the 106 cases,93 cases received microwave and bipolar coagulatioin under nasal endoscopy treatment while 13 cases digital substraction angiography(DSA).After visualization,gelfoam embolization in superselection internal maxillary artery and facial artery was found in 12 of the cases.Besides 8 patients were performed deviation of nasal septum during nosebleed withholding period.Results The outer side of posterior naris,inferior nasal meatus,sphenopalatine foramen,posterior-superior nasal septum and place near ethmoid bulla are where nose bleeding is recurrent.In 87.7% of the cases(93/106),nose bleeding was controlled iva the use of microwave and bipolar coagulation.Conclusion Microwave and bipolar coagulation under nasal endoscopy can be used as first choice in the treatment of intractable epistaxis.Unsuccessful cases of intractable epistaxis can be cured with DSA and artery infarction treatment.