重症鼻出血67例临床治疗分析

To analysis the treatment of severe epistaxis in 67 cases.

目的总结严重鼻出血的治疗方法，探讨应用鼻内窥镜技术在鼻出血治疗中的优势。方法对近5年来我院住院治疗的67例鼻出血患者进行回顾分析。结果采取前鼻孔填塞止血的13例，通过前后鼻孔填塞止血的14例，激光止血4例，内窥镜下治疗35例：其中双极电凝烧灼或填塞止血30例，内窥镜下肿物摘除5例，数字减影血管造影颌内动脉栓塞1例。67例均痊愈。结论治疗严重鼻出血的关键是明确出血原因，找到出血的部位，并根据患者不同病情采取不同治疗手段，而鼻内窥镜可准确寻找出血点，进行电凝止血，具有操作方便、痛苦小、创伤轻等优越性。

Objective To summarize the treatment of the severe epistaxis, and discuss the advantage of the nasal endoscopy in the epistaxis therapy. Methods Retrospectively analyze the last five yeas in sixty-seven patients of epistaxis. Results Only use the anterior nasal packing to stop the bleeding were thirteen cases ; use the anterior-posterior nasal packing fourteen were cases ; laser coagulation were four cases ; use the treatment under nasal endoscopy thirty-five were cases, including bipolar electric coagulation or packing were thirty cases, tumor extirpation five cases; internal maxillary artery embolization under digital subtraction angiography was one case. Sixty-seven patients all were cured. Conclusion The key of the severe epistaxis therapy was making sure the reason, finding out the accurate location and using different treatment according the different state of the illness ; the nasal endoscopy can accurately find out the location and electric coagulation. It has the advantage of expedient manipulating and relieve the distress of the patients.