出血部位不明的184例鼻出血临床诊治

Study on nasal endoscope in diagnosis and treatment of epistaxis with unknown bleeding points in 184 patients

目的探讨出血部位不明的鼻出血患者鼻内镜下检查和治疗的临床效果。方法分析总结184例出血部位不明的鼻出血患者经鼻内镜下诊治的临床资料。结果172例（93．5％）在鼻内镜下查明了鼻出血部位，并给予相应的止血处理，一次性治愈146例（79．3％）。术后2～3d再出血17例，再次处理后痊愈。术后少量间断出血21例，经一般处理治愈。痊愈出院后随访3-6个月，无一例鼻腔再出血。结论鼻内镜下诊治出血部位不明的鼻出血，定位准确、操作简便、止血可靠。对于普通鼻镜不能明视的发生于鼻腔中后部的鼻出血患者具有较高的临床应用价值。

Objective To investigate the effect of nasal endoscope in diagnosis and treatment of epistaxis with unknown bleeding points. Methods The clinical data of nasal endoscope in treating 184 cases of epistaxis with unknown bleeding points were retrospectively studied. Results 172 cases（93.5% ） of epistaxis were found the bleeding points and controlled correspindingly with nasal endoscope. 146 cases were cured only once, but 17 cases bled again during postoperative two or three days and cured by the second treatment with nasal endoscope. 21 cases bled discontinuously after operation and cured by the conventional management. Furthermore, all postcharge cured patients which followed up 2 or 3 months were not found epistaxis again. Conclusion Nasal endoscope is safe, convenient and reliable in diagnosis and treatment of epistaxis with unknown bleeding point and more valualle in patients with epistaxis in posteromedial wall of nasal meatus which not be found clearly by conventional nasoscope.