鼻内镜下电凝治疗老年人鼻出血的临床分析  

Clinical analysis of endoscopic electrocoagulation in the treatment of intractable epistaxis in elderly

作　　者：曹峰[1] 徐明安[1] 周汝环 陶礼 CAO Feng;XU Mingan;ZHUO Ruhuan;TAO Li(Department of otorhinolaryngology,second people's hospital of hefei,Anhui,Hefei 230011,China)

机构地区：[1]安徽合肥市第二人民医院耳鼻咽喉科,230011

出　　处：《中国中西医结合耳鼻咽喉科杂志》2021年第2期109-111,131,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨老年人鼻出血的临床特点及有效治疗方法。方法回顾性分析合肥市第二人民医院2015年1月~2019年5月鼻内镜下治疗75例老年人鼻出血的出血部位、疗效、与是否合并高血压病及服用抗血小板药物的关系。结果所有患者一次治疗治愈68例,二次治疗治愈7例;均找到明确出血部位,分别为:下鼻道后穹窿部27例,鼻中隔面18例,嗅裂区13例,中鼻道9例,其他出血部位8例。行鼻中隔矫正者8例。所有患者中合并高血压病患者38例,长期口服抗血小板药物35例。7例二次治愈患者均合并高血压病,有无合并高血压病的患者一次治疗治愈率差异有统计学意义(P<0.05)。有无长期口服抗血小板药物与患者一次治疗治愈率无统计学差异(P>0.05)。随访6个月均无同一部位再次出血。结论根据老年人鼻出血特点,采取有效、合理的综合治疗措施。合并高血压病的患者,应积极、有效的控制血压。鼻内镜下电凝治疗鼻出血有创伤小、暴露好、疗效佳的优点,可作为老年人鼻出血的首选治疗手段。Objective To investigate clinical features of intractable epistaxis in elderly and the effect of endoscopic electrocoagulation.Methods Retrospective analysis was conducted on the bleeding site,curative effect and the relationship between effect and hypertension or taking antiplatelet agents in 75 elderly patients in Hefei second people's hospital from January 2015 to May 2019.Result All patients were cured,in whom 68 patients received one time of treatment and the rest received twice.All the bleeding sites were identified under endoscope,including 27 cases at the posterior inferior nasal meatus,18 cases on the nasal septum,13 cases in the area of olfactory cleft,9 cases in the middle meatus and 8 cases in other location.8 patients received septoplasty.Among all the patients,38 patients were complicated with hypertension and 35 patients has history with long-term taking antiplatelet drugs.Hypertension was found in all 7 patients treated twice.The difference of the one-time curative rate between patients with and without hypertension was statistically significant(P<0.05).The one-time curative rate was not associated with long-term use of antiplatelet drugs(P>0.05).No repeated epistaxis at the same site was observed during the six-month follow-up period.Conclusions According to the characteristics of the elderly nasal hemorrhage,effective and reasonable comprehensive treatment measures should be taken as soon as possible.Patients with hypertension should be effectively controlled blood pressure.The treatment of epistaxis under nasal endoscopy has the advantages of minimal invasive,good exposure and good curative effect,which can be the first choice for the treatment of nasal hemorrhage in the elderly.

关 键 词：鼻出血 鼻内镜 老年人 高血压 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]