鼻中隔相关性鼻出血的临床特点和疗效分析  

作　　者：蒋建华[1] 解道宇 柏志香 杨小虎 丁吉女[1] 田如如 周国文[1] 

机构地区：[1]杭州师范大学附属医院,310015 [2]杭州师范大学临床医学院,311121

出　　处：《浙江临床医学》2024年第2期243-244,247,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2021KY896)。

摘　　要：目的探讨鼻中隔相关性鼻出血的有效治疗方法和治疗效果。方法回顾分析本院2019年7月至2022年4月住院治疗的120例鼻出血患者,均经鼻内镜检查明确出血点且与鼻中隔相关,分别用鼻腔填塞(观察组)、电凝止血(对照组)和鼻中隔矫正及电凝止血术(试验组),比较分析三组治疗效果。结果试验组首次止血成功率100%,术后3个月随访无再出血者;对照组首次止血成功率80.95%,8例需再次出血,术后3个月随访再出血率13.51%;观察组首次止血成功率77.42%,7例需再次填塞后止血,术后3个月随访再出血率32.26%。三组比较差异具有统计学意义(P<0.05)。结论鼻中隔相关性鼻出血在全身麻醉鼻内镜下电凝止血联合鼻中隔矫正手术治疗鼻腔出血较单纯电凝止血和鼻腔填塞止血效果更佳,且降低鼻腔填塞物导致患者鼻面部胀痛不适感,且治愈率高,在患者条件允许情况下值得临床推广。Objective To explore the effective treatment and effect of nasal septum related epistaxis.Methods 120 patients with epistaxis who were hospitalized in our department from July 2019 to April 2022 were retrospectively analyzed.The bleeding points were identified by nasal endoscopy and were related to nasal septum.Nasal packing(the observation group),electrocoagulation hemostasis(the control group)and nasal septum correction and electrocoagulation hemostasis(the experimental group)were used respectively to compare and analyze the treatment effects of the three groups.Results The success rate of the first hemostasis was 100%in the experimental group,and there was no rebleeding in the 3-month follow-up;In the control group,the success rate of the first hemostasis was 80.95%,8 cases needed to bleed again,and the rebleeding rate was 13.51%in the 3-month follow-up.In the observation group,the success rate of the first hemostasis was 77.42%,and 7 cases needed to be tamped again to stop bleeding.The rebleeding rate was 32.26%in the 3-month follow-up.The difference among the three groups was statistically significant(P<0.05).Conclusion Under general anesthesia and nasal endoscopy,electrocoagulation hemostasis combined with nasal septum correction surgery for nasal bleeding is better than simple electrocoagulation hemostasis and nasal packing hemostasis,and it can reduce the discomfort of nasal and facial swelling caused by nasal packing,and the cure rate is high.It is worthy of clinical promotion if the patient's conditions permit.

关 键 词：鼻出血 鼻中隔偏曲 鼻中隔骨折 鼻中隔血管瘤 鼻内镜检查 鼻中隔矫正术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]