鼻内镜下双极电凝治疗顽固性鼻出血对患者出血量、鼻腔通气及应激反应的影响  

Effects of bipolar electrocoagulation under nasal endoscopy on bleeding volume,nasal ventilation and stress response in patients with intractable epistaxis

作　　者：马辉娟 房红娟 李晓瑞 田小娟 MA Hui-juan;FANG Hong-juan;LI Xiao-rui;TIAN Xiao-juan(Department of Otorhinolaryngology Head and Neck Surgery,Yuncheng Central Hospital,Yuncheng 044000,Shanxi,China)

机构地区：[1]运城市中心医院耳鼻咽喉头颈外科,山西运城044000

出　　处：《川北医学院学报》2022年第10期1337-1340,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨鼻内镜下双极电凝治疗顽固性鼻出血对患者出血量、鼻腔通气及应激反应的影响。方法:选取112例顽固性鼻出血患者为研究对象,按照治疗方法不同分为填塞组和电凝组,每组各56例。填塞组行传统填塞治疗;电凝组行鼻内镜下双极电凝治疗。比较两组患者治疗后的出血量、鼻腔通气阻力、嗅觉功能及鼻腔粘膜恢复时间、应激反应程度、临床疗效、术后并发症及复发情况。结果:电凝组患者治疗后鼻腔总出血量少于填塞组(P<0.05);鼻腔恢复通气时间及鼻腔粘膜恢复时间均短于填塞组(P<0.05)。与填塞组比较,电凝组患者单侧吸气阻力(IR)及呼气阻力(ER)、双侧吸气总阻力(TIR)及呼气总阻力(TER)均降低(P<0.05)。治疗后,两组患者血清肾上腺素(E)、去甲肾上腺素(NE)及皮质醇水平均升高(P<0.05),且填塞组高于电凝组(P<0.05)。电凝组治疗顽固性鼻出血的总有效率高于填塞组(P<0.05)。随访3个月,电凝组患者并发症总发生率及复发率低于填塞组(P<0.05)。结论:相比传统填塞治疗,鼻内镜下双极电凝治疗顽固性鼻出血疗效更好,术后应激程度相对较轻,鼻通气功能恢复更好,且并发症发生率及复发率较低,值得推广应用。Objective:To explore the effects of bipolar electrocoagulation under nasal endoscopy on bleeding volume,nasal ventilation and stress response in patients with intractable epistaxis.Methods:112 patients with intractable epistaxis were selected as study subjects.They were divided into tamponade group and electrocoagulation group according to different treatment methods,with 56 cases in each group.The tamponade group was treated with traditional tamponade and the electrocoagulation group was treated with bipolar electrocoagulation under nasal endoscope.After treatment,the bleeding volume,nasal ventilation resistance,olfactory function,recovery time of nasal mucosa,degree of stress response,clinical efficacy,postoperative complications and recurrence were compared between the two groups.Results:The total nasal bleeding volume in electrocoagulation group was less than that in tamponade group(P<0.05),and the nasal ventilation recovery time and nasal mucosal recovery time were shorter than those in tamponade group(P<0.05).Compared with tamponade group,the unilateral inspiratory resistance(IR)and expiratory resistance(ER),bilateral total inspiratory resistance(TIR)and total expiratory resistance(TER)of patients in electrocoagulation group were significantly reduced(P<0.05).After treatment,the levels of serum epinephrine(E),norepinephrine(NE)and cortisol of the two groups were higher than those before treatment(P<0.05),and the tamponade group after treatment were higher than the electrocoagulation group(P<0.05).The total effective rate of the electrocoagulation group was higher than that in the tamponade group(P<0.05).3 months of follow-up,the total incidence rate of complications and the recurrence rate of electrocoagulation group was lower than those of tamponade group(P<0.05).Conclusion:Compared with the traditional packing treatment,bipolar electrocoagulation under nasal endoscopy has a good efficacy,relatively mild postoperative stress and good recovery of nasal ventilation function in the treatment of intractable ep

关 键 词：鼻内镜 双极电凝治疗 顽固性鼻出血 应激反应 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]