难治性鼻出血不同治疗方法的对比观察

A comparative observation on different treatment of intractable epistaxis

目的：通过对难治性鼻出血3种止血方法治疗效果的比较观察，探求最优的止血方法。方法：总结自1998年1月至2007年12月的126例难治性鼻出血患者，分别行前后鼻孔栓塞止血、鼻内镜下局部填塞止血及鼻内镜引导下低温射频止血，观察各种方法的疗效及患者耐受性的影响。结果：3种止血方法治疗效果差异显著（P〈0．05），前后鼻孔栓塞对患者的耐受性影响较大。结论：鼻内镜下低温射频结合局部填塞治疗难治性鼻出血效果好、对患者的耐受性影响小，值得临床推广。

Objective： In order to clarify the optimum method to control intractable epistaxis,we compared and observed three methods to control intractable epistaxis. Methods： 68 patients were treated with anterior-posterior nasal tamponing. The hemorrhagic spots were found out by nasal endoscopy in the remain 58 patients. When hemorrhage points occur, ENTec--Coblator and glutin sponge or Meroeel mini packing is conducted to control their epistaxis ,then the results of these treatments were observed comparatively. Results： There were significant differences among the three methods （P 〉0. 05）, the patients with nasal tamponing got more suffering. Conclusion： Each has its strong point among the four methods, hut radiofrequency is the best treatment to control epistaxis. Endoscopic ENTec-Coblator and glutin sponge or Merocel mini packing treatment for intractable nasal bleeding is a microinvasive and efective method..