医用胶粘合零填塞技术治疗鼻出血的疗效分析  

Analysis of efficacy of medical adhesives and zero-packing technology in the treatment of epistaxis

作　　者：刘雪峰 杨蒙生[1] 李丽[1] 杨小龙[1] 卫旭东[1] 何健[1] LIU Xuefeng;YANG Mengsheng;LI Li;YANG Xiaolong;WEI Xudong;HE Jian(Department of Otolaryngology Head and Neck Surgery,Gansu Provincial People's Hospital,Gansu,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院耳鼻咽喉头颈外科,甘肃兰州730000

出　　处：《中国医药科学》2020年第18期14-17,31,共5页China Medicine And Pharmacy

基　　金：甘肃省人民医院院内科研基金(18GSSY5-10)。

摘　　要：目的观察应用医用胶粘合零填塞技术治疗鼻出血的疗效。方法回顾性分析2014年5月~2019年1月甘肃省人民医院耳鼻咽喉头颈外科门诊部诊疗,且经鼻内窥镜检查并保存有影像资料的鼻出血病例共228例,按照门诊治疗方式不同分为零填塞组、硬填塞组及软填塞组,分别统计患者术中疼痛度、出血量及手术时间,术后48h抽取鼻腔填塞物后鼻腔黏膜糜烂度、再出血率以及术后1周时生活质量评分和治疗有效率。结果零填塞组相对于硬填塞组及软填塞组,疼痛度轻,术中出血量稍多,手术时间略长,黏膜糜烂度轻,再出血率小,术后生活质量评分高,治疗有效率高,差异有统计学意义(P<0.05)。结论鼻内镜下应用医用胶粘合零填塞技术是治疗鼻出血的一种微创安全有效方法,值得临床推广。Objective To observe the curative effect of medical adhesives and zero-packing technology in the treatment of epistaxis.Methods A total of 228 cases of epistaxis who were treated in the outpatient department of Otolaryngology Head and Neck Surgery of Gansu Provincial People's Hospital from May 2014 to January 2019 and diagnosed by nasal endoscopy and had complete image data were retrospectively analyzed.The patients were divided into the zero-packing group,the hard-packing group and the soft-packing group.The patients'intraoperative pain,bleeding volume and operation duration,the nasal cavity mucosa erosion degree at 48 hours after surgery followed by the extraction of nasal cavity packing stuffs,re-bleeding rate and the quality of life score and treatment efficiency at 1 week after surgery were counted respectively.Results Compared with the hardpacking and soft-packing groups,the zero-packing group had mild pain,much intraoperative bleeding,longer operation duration,lighter mucosal erosion,lower re-bleeding rate,higher postoperative quality of life score,and higher treatment efficiency,and the differences were statistically significant(P<0.05).Conclusion The medical adhesives and zero-packing technology under nasal endoscope is a minimally invasive,safe and effective method for the treatment of epistaxis,which is worthy of clinical promotion.

关 键 词：鼻出血 软填塞 硬填塞 零填塞技术 

分 类 号：R765.23[医药卫生—耳鼻咽喉科]