隐蔽性鼻出血常见出血部位及治疗策略  

Common bleeding sites and treatment strategies of refractory and hidden epistaxis

作　　者：韩浩伦[1] 吴玮[1] 王鸿南[1] 李保卫[1] 王刚[1] 王磊[1] 孙喆喆[1] 丁瑞英[1] 

机构地区：[1]解放军第306医院耳鼻咽喉头颈外科,北京100101

出　　处：《总装备部医学学报》2015年第3期141-143,共3页Medical Journal of General Equipment Headquarters

摘　　要：目的探讨隐蔽性鼻出血的常见出血部位及其治疗策略。方法回顾性分析2007年10月~2013年10月我科收治的隐蔽性鼻出血75例,统计分析其出血部位,探讨其治疗策略。结果本组隐蔽性鼻出血部位依次为下鼻道穹窿部25例、嗅裂21例、鼻腔顶壁11例、下鼻甲后端附着处9例、中鼻道后端穹窿部6例和后鼻孔吴氏区3例。本组经一次治疗止血66例,再次出血9例;再次出血者使用相同方法处理后止血3例,经全身麻醉下鼻中隔偏曲矫正术后止血6例。追踪随访4周内未再次发生鼻出血。结论大部分隐蔽性鼻出血经过全面细致的鼻内窥镜检查可以明确出血点,用双极或单极电凝凝固止血辅助以微填塞,止血效果确切,必要时行鼻中隔矫正以寻找出血点并有效止血。Objective To study the common nasal bleeding sites and treatment strategies of refractory and hidden epistaxis. Methods A retrospective analysis of clinical data in 75 patients admitted to our department with refractory and hidden epistaxis during October 2007 to October 2013 were carried out and the sites of bleeding and treatment strategies were analyzed. Results The of refractory,hidden epistaxis bleeding were inferior meatus fornix(25cases),olfactory cleft(21cases),nasal top wall(11cases),and the bottom section of superior tuibinate(9cases),middle meatus fornix(6cases)and Wu's area of nasopharynx(3cases).Through detailed,multi-angle endoscopic examination,the bleeding site could be determined in most patients.By using a singlestage bipolar coagulation or clotting,most bleeding was stopped;if necessary,micro-packing was able to stop the bleeding.The patients of nasal bleeding with significant deviation were deviated with septum corrective surgery. Conclusions After a detailed and thorough endoscopy we can clarify the most nose bleeding sites of patients.It has exact effect on the patients by using single-stage bipolar coagulation or micro-packing;if necessary,corrective surgery of nasal septum is performed to find the bleeding site and to give effective hemostasis.

关 键 词：鼻出血 治疗 

分 类 号：R765.23[医药卫生—耳鼻咽喉科]