难治性鼻出血的诊治

Experience in diagnosis and treatment of 62 cases of instractable epistaxis

目的:探讨难治性鼻出血的出血部位及检查治疗方法。方法:对62例经2次以上常规填塞未能止血的难治性鼻出血患者进行回顾性分析。结果:出血部位依次为:下鼻道后段、嗅裂区、中鼻道后段、鼻中隔后缘、鼻咽静脉丛。62例患者中51例1次填塞成功,10例经2次填塞,1例填塞无效,后经动脉造影血管栓塞治疗。随诊1个月,无复发病例。结论:详细的纤维鼻咽镜或鼻内镜检查对探察鼻腔深部出血具有重要意义,是止血的关键。

Objective：To investigate the commonnasal bleeding points and the management of intractable epistaxis. Methods： Thee bleeding points and treatment were studied retrospectively in 62 patients whose bleeding points were not found by routine rhinoscopy and the hemorrhage was not controlled through 2 times and standard nasal packing. Results： The bleeding points were found in the follow different sites： posterior of inferior nasal meatus, olfactory deft, posterior of middle nasalmeatus, posterior edge of nasal septum, Woddruff plexus and uncertain. Among 62 cases, 51 cases were cured after 1 time of nasal packing, 10 cases were cured after 2 times and 1 cases was invalidity. Conclusions：Detailed cheek with endoscopy is very significant to found the deeply- sited bleeding points, which is the key of controlling intractable epistaxis.