鼻内镜下治疗老年患者鼻腔后部出血的疗效观察  

Clinical analysis of nasal endoscopy for the treatment of elderly patients with epistaxis

作　　者：章晓军[1] 吕洁瑜[1] 张梦雯 叶健泳 ZHANG Xiaojun;LV Jieyv;ZHANG Mengwen;YE Jianyong(Department of Otolaryngology,Jiangmen Central Hospital,Jiangmen,Guangdong,529000,China)

机构地区：[1]广东江门市中心医院耳鼻咽喉科,529000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2021年第4期267-269,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的分析两种不同的手术方式在鼻内镜治疗老年患者鼻腔后部出血的疗效。方法回顾性分析2017~2018年于我院就诊的老年鼻出血149例患者(年龄≥60岁)的临床资料,将对象按手术方式分为双极电凝治疗组(Ⅰ组)和等离子电刀组(Ⅱ组),分别比较不同术式术后1个月的有效率,两组手术时间的差异,以及鼻腔后部鼻出血部位的分布情况,两组患者的术后创面疼痛情况。结果两组老年患者鼻出血的治疗率差别无统计学意义,但Ⅱ组的患者手术时间少于Ⅰ组,(P<0.05),差别有统计学意义,老年患者鼻腔出血的部位前三位的是:中鼻道末端、嗅裂鼻中隔部、中鼻道后上部,等离子电刀组术后创面疼痛小。结论老年鼻出血患者行鼻内镜下等离子电凝止血治疗,手术时间短,特别对鼻腔隐匿部位的止血疗效好。Objective To analyze the effect of two different surgical methods on nasal endoscopic treatment of nasal bleeding in the back of the nasal cavity of elderly patients.Methods To retrospectively analyze the clinical data of 149 elderly patients(age≥60 years)with epistaxis in our hospital from 2017 to 2018.The subjects were divided into bipolar electrocoagulation treatment group(group I)and plasma electrocautery group(group II),to compare the effective rate of 1 month after different operation,difference in operation time between the two groups,the distribution of nasal bleeding in the back of the nasal cavity,and the postoperative pain of the two groups.Results There was no statistically significant difference in the treatment rate of nose bleeding between the two groups of elderly patients,however,the operation time of patients in groupⅡwas shorter than that in group I(P<0.05),the difference was statistically significant.The top three sites of nasal bleeding in elderly patients were:the end of the middle nasal canal,the olfactory cleft of nasal septum,and the upper back part of middle nasal meatus.The plasma electrocautery group had less postoperative wound pain.Conclusion Elderly patients with epistaxis choose endoscopic hemostatic therapy with plasma knife under nasal endoscopy.The operation time is short,especially for the hemostatic effect of the hidden part of the nasal cavity.

关 键 词：鼻内镜 老年患者 鼻出血 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]