鼻内镜下蝶腭动脉电凝术治疗顽固性鼻出血的疗效观察

Endoscopic diathermy of the sphenopalatine artery as the primary management for refractory epistaxis

目的探讨应用鼻内镜行蝶腭动脉电凝术治疗顽固性鼻出血的疗效及可能的并发症。方法对40例出血来源于鼻腔后部、位点不明、经多次鼻腔填塞或其他处置依然反复发作的顽固性鼻出血患者于全身麻醉后在鼻内镜下行蝶腭动脉电凝术。结果短期随访2—29天，平均10天，长期随访5月～2年，平均10个月。短期止血成功率95．0％，并发症18例；长期随访止血成功率90．0％，并发症3例。结论鼻内镜下蝶腭动脉电凝术治疗顽固性鼻出血疗效确切、手术微创、并发症发生率低，是治疗顽固性鼻出血的可靠方法。

Objective To investigate tile complication and efficacy of endoscopic sphenopalatine artery diathermy in management of refractory epistaxis. Methods 40 patients with severe intractable posterior epistaxis, who had underwent various procedures like nasal packing, electro - or chemical cautery or others and still exacerbated, were subjected to this study. Under general anesthesia, endoscopic diathermy of the sphenopalatine artery was performed. Results 40 patients have been followed up for 2 to 29 days with an average of 10 days in the recent time and 5 months to 2 years with an average of 10 months in the long time. Cure rate was 95.0%and 18 patients had some complications.The long- term results was 90.0%of the cured rate and 3 patients trad some complications. Conclusion Diathermy of sphenopalatine artery, as a purely endonasal procedure, is an effective and mieroin- vasive means of achieving long - term control of refractory epistaxis. It has few of the complications associated with other forms.