难治性鼻出血的临床治疗

Clinical therapic procedure of intractable epistaxis

目的探讨难治性鼻出血的临床处理思路及治疗经验。方法回顾性分析156例难治性鼻出血患者的临床资料,针对出血患者采用序贯治疗:首先应用鼻内窥镜检查鼻腔并在内镜下射频或电凝止血,上述方法治疗无效者,采用数字减影血管造影(DSA)上颌动脉栓塞治疗。结果156例患者,鼻内窥镜检查和治疗一次性治愈139例,二次治愈6例,治愈率为92.9%。经鼻内窥镜检查和治疗后出血仍未能控制者11例,行血管造影并栓塞治疗,治愈率为100%。结论采用鼻内镜技术结合数字减影血管造影两种方法序贯治疗难治性鼻出血,疗效满意。

Objective To investigate the clinical treatment consideration and the therapic experience of intractable epistaxis. Methods The clinical data of 156 cases of intractable were retrospectively analyzed, The sequential therapy was selected to the treatment：first, using the methods including nasendoscopy and radio frequency or electric coagulation to stop bleeding, when these methods were ineffective, then Used digital subtraction angiography localization and embolization. Results All of the patients, the numbers of nasendoscopy treatment needed to stop bleeding were 139 cases after 1 time of treatment,6 cases after 2 times,the cure rate was 92. 9 %, there were 11 cases could not control, then Used digital subtraction angiography localization and embolization, the cure rate was 100%. Conclusion The thought of taking sequential therapy methods to treat the intractable epistaxis was very clear,and the curative effect is satisfactory as well.