合并鼻中隔偏曲的难治性鼻出血42例临床诊治分析

Clinical analysis on 42 cases of refractory nasal bleeding combined with nasal septum deviation

目的探讨合并鼻中隔偏曲的难治性鼻出血的临床诊治方法及其效果。方法回顾性分析2008年1月～2013年3月本院收治42例合并鼻中隔偏曲的难治性鼻出血患者临床资料，总结合并鼻中隔偏曲的难治性鼻出血的临床诊治策略。结果5例未明确出血部位行鼻中隔矫正术后仍出血，行鼻内镜检查明确出血部位低温射频止血成功，33例鼻中隔偏曲不影响鼻内镜检查而鼻内镜检查明确出血部位后低温射频止血成功，4例因鼻中隔偏曲明显鼻内镜检查困难同期行鼻内镜下鼻中隔矫正加低温射频止血成功。结论鼻中隔偏曲并难治性鼻出血的治疗首先应在鼻内镜下明确出血部位，若未明确出血部位不应盲目行鼻中隔矫正术，若鼻中隔偏曲影响鼻内镜检查则应同期行鼻中隔矫正加低温射频止血。

Objective To investigate the clinical method in the treatment of refractory nasal bleeding combined with nasal septum deviation and its effect. Methods Retrospective analysis of 2008 January to 2013 March in our hospital 42 cases patients with clinical data, diagnosis and treatment of refractory nasal bleeding combined with deviation of nasal septum. Results 5 cases not clear bleeding site for correction of nasal septum is still bleeding, nasal endoscopy clear bleeding site radiofrequency hemostasis success, 33 cases of nasal septum deviation does not affect the nasal endoscopy and endoscopic examination clear radiofrequency hemostasis success, 4 cases with deviation of nasal septum nasal endoscopy was difficult period endoscopic nasal septum and low temperature RF hemostatic success. Conclusion Treatment of refractory nasal bleeding combined with nasal septum should first clear the site of bleeding in endoscopic, if not clear bleeding site should not blindly for correction of deviation of nasal septum, if the effect of nasal endoscopic examination should be combined with nasal septum correction and low temperature RF hemostasis.