鼻内镜下同期行鼻中隔成形术治疗顽固性鼻出血合并鼻中隔偏曲的疗效  

Observation on the therapeutic effect of simultaneous nasal septoplasty under nasal endoscopy in the treatment of intractable nasal bleeding complicated with nasal septum deviation

作　　者：程忠强 袁润生 王伟 强化龙 蒋成义 詹晓东 CHENG Zhongqiang;YUAN Runsheng;WANG Wei;QIANG Hualong;JIANG Chengyi;ZHAN Xiaodong(Department of Otolaryngology/Head and Neck Surgery,The First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2024年第5期590-592,596,共4页Journal of Bengbu Medical College

基　　金：安徽省高校自然科学研究重点项目(KJ2021A0751);蚌埠医学院自然科学研究重点项目(2021byzd070)。

摘　　要：目的:探讨鼻内镜下同期行鼻中隔成形手术对顽固性鼻出血合并鼻中隔偏曲的临床疗效及安全性。方法:选取126例顽固性鼻出血伴鼻中隔偏曲病人,随机分为观察组和对照组,各63例。观察组采用鼻内镜下同期鼻中隔成形术治疗,对照组行鼻内镜下射频探查止血术。比较2组手术时间、临床手术疗效、并发症和复发情况以及术后1周、1、6个月鼻部VAS评分和鼻阻力。结果:观察组手术时间长于对照组(P<0.05)。观察组临床手术疗效明显优于对照组(P<0.01)。观察组术后1、6个月VAS评分和鼻阻力均低于对照组(P<0.05~P<0.01)。2组术后鼻中隔疾病并发症差异无统计学意义(P>0.05),观察组术后复发及鼻腔粘连发生情况均低于对照组(P<0.05)。结论:对于顽固性鼻出血合并鼻中隔偏曲的治疗,鼻内镜下同期行鼻中隔成形术虽手术时间有所延长,但可明显提高临床疗效,并可显著改善鼻腔症状,降低术后鼻出血复发。Objective:To investigate the clinical efficacy and safety of simultaneous nasal septoplasty under nasal endoscopy for intractable nasal bleeding complicated with nasal septum deviation.Methods:A total of 126 patients with intractable nasal bleeding complicated with nasal septum deviation were selected and randomly divided into an observation group and a control group,with 63 cases in each group.The observation group underwent simultaneous nasal septoplasty under nasal endoscopy,while the control group received nasal endoscopic radiofrequency exploration hemostasis surgery.The operation time,clinical surgical efficacy,complications and recurrence between the two groups,as well as nasal VAS score and nasal resistance at 1 week,1 month,and 6 months after surgery were compared.Results:The operation time in the observation group was longer than that in the control group(P<0.05).The clinical surgical efficacy in the observation group was significantly better than that in the control group(P<0.01).The VAS score and nasal resistance in the observation group were lower than those in the control group at 1 month and 6 months after surgery(P<0.05 to P<0.01).There was no statistically significant difference in postoperative complications of nasal septum disease between the two groups(P>0.05).The incidence of postoperative recurrence and nasal adhesions in the observation group was lower than that in the control group(P<0.05).Conclusions:For the treatment of intractable nasal bleeding complicated with nasal septum deviation,simultaneous nasal septoplasty under nasal endoscopy may prolong the operation time,but it can significantly improve clinical efficacy,improve nasal symptoms,and reduce postoperative recurrence of nasal bleeding.

关 键 词：鼻出血 鼻中隔偏曲 鼻中隔成形术 

分 类 号：R765.25[医药卫生—耳鼻咽喉科]