鼻内镜下双极电凝止血治疗难治性鼻出血的临床分析  

Clinical Analysis of Bipolar Electrocoagulation and Hemostasis under Nasal Endoscope in the Treatment of Refractory Nasal Hemorrhage

作　　者：许国志 XU Guozhi(Department of Otolaryngology,Shangcai Chongyang hospital,Zhumadian Henan 463800,China)

机构地区：[1]上蔡重阳医院耳鼻咽喉科,河南驻马店463800

出　　处：《临床研究》2022年第11期39-42,共4页Clinical Research

摘　　要：目的研究鼻内镜下双极电凝止血对难治性鼻出血的影响。方法本研究按照随机排列法将上蔡重阳医院2019年1月至2021年12月接收的76例难治性鼻出血患者进行分组,研究组(38例)开展鼻内镜下双极电凝止血,对照组(38例)采取常规鼻腔填塞法。治疗后评价两组有效率,比较两组出血量、止血、鼻腔黏膜恢复及鼻腔恢复通气时长、治疗前后的氧化应激指标[去甲肾上腺素(NA)、肾上腺素(E)、皮质醇(Cor)]以及生活质量、并发症及复发率。结果研究组有效率(92.11%)高出对照组(71.05%),差异有统计学意义(P<0.05)。研究组出血量低于对照组,且止血、鼻腔黏膜恢复及鼻腔恢复通气时长均短于对照组,差异有统计学意义(P<0.05)。治疗前两组氧化应激指标差异无统计学意义(P>0.05),治疗后研究组NA、E、Cor均高出对照组,差异有统计学意义(P<0.05)。治疗前两组生活质量差异无统计学意义(P>0.05),治疗后研究组精神、躯体、社会、生理评分均高出对照组,差异有统计学意义(P<0.05)。研究组并发症(10.53%)、复发率(5.26%)低于对照组(31.58%、26.32%),差异有统计学意义(P<0.05)。结论鼻内镜下双极电凝止血的效果更好,同时可缩短病情恢复时长,改善氧化应激指标,促进生活质量改善,并发症及复发率较低。Objective To study the effect of bipolar electrocoagulation on refractory epistaxis under nasal endoscope.Methods According to the random arrangement method,76 patients with refractory nasal hemorrhage admitted to Shangcai Chongyang Hospital from January 2019 to December 2021 were divided into the study group(N=38,nasal endoscopic bipolar electrocoagulation),and the control group(N=38,routine nasal cavity filling).After treatment,the effective rate of the two groups was evaluated.The amount of blood loss,hemostasis,nasal mucosa recovery and nasal ventilation time,oxidative stress indicators[norepinephrine(NA),epinephrine(E),cortisol(Cor)]before and after treatment,quality of life,complications and recurrence rate were compared between the two groups.Results The total effective rate in the study group(92.11%)was higher than the control group(71.05%)(P<0.05);the blood loss in the study group was lower than that in the control group;and the duration of hemostasis,nasal mucosal recovery and nasal ventilation recovery were shorter than those in the control group,and the differences were statistically significant(P<0.05);There was no significant difference in oxidative stress index between the two groups before treatment(P>0.05).After treatment,NA,E,and Cor in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in the quality of life between the two groups(P>0.05).After treatment,the mental,physical,social and physiological scores of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).The complication rate(10.53%)and recurrence rate(5.26%)in the study group were lower than those in the control group(31.58%,26.32%),and the differences were statistically significant(P<0.05).Conclusion Bipolar electrocoagulation under a nasal endoscope has a better effect on hemostasis and can shorten the recovery time of the disease,improve the indicator

关 键 词：难治性鼻出血 鼻内镜下双极电凝止血 常规鼻腔填塞法 

分 类 号：R765.23[医药卫生—耳鼻咽喉科]