鼻内镜下不同激光治疗鼻出血的临床效果及生活质量对比  

Comparison of clinical effect and quality of life between different laser treatments of nasal bleeding under nasal endoscopy

作　　者：刘艳武[1] LIU Yanwu.(Jilin Provincial Corps Hospital of Chinese People＇ s Armed Police Force, Changchun 130052, China)

机构地区：[1]武警吉林总队医院耳鼻喉科,长春130052

出　　处：《武警医学》2018年第4期341-343,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的通过对比鼻内镜下CO_2激光与Nd∶YAG激光治疗鼻出血的临床效果及生活质量,为鼻出血患者的治疗提供参考。方法以2016-03至2017-02收治的240例鼻出血患者为研究对象,按照患者的入院顺序将其分为对照组和观察组,两组各120例。对照组采用CO_2激光治疗,观察组采用Nd∶YAG激光治疗。术后随访3个月,观察两组患者的各项手术指标、近期疗效及预后情况,并采用生活质量综合评分(GQOLI-74)评价患者的生活质量。结果观察组手术时间及止血时间均短于对照组,术中出血量少于对照组,鼻出血次数少于对照组,术后首次出血时间长于对照组,生活质量评分高于对照组,上述指标差异均有统计学意义(P<0.05);观察组止血成功率98.3%高于对照组81.7%,术后3个月发生主观嗅觉减弱率0.8%低于对照组10.0%,差异有统计学意义(P<0.05)。结论与鼻内镜下CO_2激光治疗相比,鼻内镜下Nd∶YAG激光治疗鼻出血患者,能够改善手术指标,提高近期疗效,改善预后及生活质量。Objective To compare the clinical effect and quality of life of patients with nasal bleeding treated with CO2 laser and Nd∶ YAG laser under nasal endoscopy in order to provide reference for related treatment. Methods 240 cases of epistaxis treated between March 2016 and February 2017 were selected. These patients were equally divided into the control group and the observation group according to the time of admission. The control group was treated with CO2 laser,while the observation group was treated with Nd∶ YAG laser. The follow-up was 3 months. The operation indexes,short-term curative effect and prognosis of the two groups of patients were observed. Quality of life assessment（ GQOLI-74） was used for evaluating the quality of life of patients. Results The duration of surgery and hemostasis in the observation group were shorter than those of the control group,the amount of pereoperative bleeding was smaller,so was the amount of nose bleeding,but the score of quality of life was higher than that of the control group,and the difference of the above indexes was statistically significant（ P〈0. 05）. The success rate of hemostasis in the observation group was 98. 3%,higher than that of the control group（ 81. 7%）. The reduced rate of subjective olfaction 3 months after operation was 0. 8%,much lower than that of the control group（ 10%）,and the difference was statistically significant（ P〈0. 05）. Conclusions Compared with CO2 laser treatment under nasal endoscope,Nd YAG laser under a nasal endoscope can improve operative indexes,short-term curative effect,prognosis and quality of life,so it is worthy of wider application.

关 键 词：鼻内镜 CO2激光 Nd∶YAG激光 鼻出血 生活质量 

分 类 号：R765.23[医药卫生—耳鼻咽喉科]