鼻出血好发部位及意义

Location and significance of epistaxis

目的明确鼻出血常见的出血部位以及探讨其对经前鼻镜鼻腔填塞治疗的指导意义。方法2005年5月至2006年12月共190例患者经前鼻镜检查未能发现出血点,对其中的156例患者行鼻内窥镜检查及填塞,并总结鼻出血好发部位与年龄的关系;对34例因各种原因无法行鼻内镜检查治疗者根据总结的结果经前鼻镜分别行嗅裂区、下鼻道填塞。结果156例患者出血部位依次为:下鼻道顶部57.1%(89/156)、嗅裂区29.5%(46/156)、后鼻孔缘及鼻底部后端8.3%(13/156),其余部位出血及未发现出血部位5.1%(8/156)。出血部位与年龄有一定的相关性,59岁以下年龄组以下鼻道顶部出血最常见69.7%(83/119),而60岁以上组则以嗅裂区易出血63.9%(23/36)。34例未行鼻内镜检查患者,根据我们总结的结果填塞后,91.2%(31/34)得到治愈。结论鼻内镜技术对于明确鼻腔出血部位具有重要意义。对前鼻镜检查未能发现出血点,而患者又经济困难,鼻腔较狭窄无法进行鼻内窥镜检查以及尚未开展鼻内镜止血的医院,嗅裂区、下鼻道予以明胶海绵填塞也有良好的治疗效果。

Objective To demonstrate the location of epistaxis and evaluate the value for epistaxis treatment via anterior rhinoscopy. Methods One hundred and ninety patients of epistaxis were enrolled from May 2005 to Dec 2005. Among them, the locations were examined and the nasal cavity were packed via endoscope. While 34 were packed via anterior rhinoscopy according the results got from examination via endoscope. Results The main location was at the ceiling of the inferior meatus（89/155） and olfactory sulcus which occupy about 57.1% and 29.5% respectively. 31 out 34 patients were cured via anterior rhinoscopy. Conclusion Using endoscope is helpful to find the location. However, nasal pack on the main locations of epistaxis via anterior rhinoscopy can also get the relatively good results.