鼻内镜下治疗鼻出血206例疗效观察

Observation of Curative Effect of Nasal Bleeding under Nasal Endoscopy in 206 Cases

目的探讨鼻内镜下治疗鼻出血的手术方法和疗效。方法收集耳鼻喉科2008年2月-2012年2月因反复出血行鼻内镜检查止血术的206例鼻出血患者临床资料。在鼻内镜直视下明确出血情况,根据病情不同选择单极电凝烧灼、可吸收明胶海绵保护创面或凡士林纱条局部填塞等不同的止血方法止血,观察疗效。结果 1次手术治愈179例(86.9%),2次手术治愈21例(10.2%),3次手术治愈6例(2.9%),总有效率100%。术中发现鼻中隔偏曲12例,鼻息肉3例,鼻微小血管瘤3例,除微小血管瘤术中处理外,余嘱1个月后手术治疗。随访3～6个月无一例再出血,无鼻腔粘连、鼻中隔穿孔、心脑血管意外等不良并发症发生。结论鼻内镜下探查止血术具有准确、有效、无痛、安全等优点,大大减少患者的痛苦,值得临床推广应用。

Objective To investigate the operation method and effect of nasal bleeding under nasal endoscopy.Methods The clinical data of 206 cases with nasal bleeding treated under nasal endoscopy were analyzed retrospectively from February 2008 to February 2012.Different hemostatic methods such as monopole electrocautery cauterization,wound protection with absorbable gelfoam,and local packing with vaseline gauze were selected according to individual needs,and the curative effect were observed.Results 179 cases were cured at the first time（86.9%）,21 cases at two times（10.2%） and 6 cases at three times（2.9%）,and the overall response rate was 100%.Nasal septum deviation was found in 12 cases,nasal polyps in 3 cases and nasal minimal hemangioma in 3 cases during operation.Except that the 3 cases of nasal minimal hemangioma were treated intraoperatively,the others were operated after one month.The patients were followed up for 3 to 6 months without any recurrence or adverse complication such as recurrent hemorrhage,nasal adhesion,perforation of nasal septum,and cordis and cerebral accidents and so on.Conclusion Nasal endoscopy was a safe and effective method in treating nasal bleeding with little pain and worthwhile for spreading in clinical practice.