鼻内镜下电凝止血与局部填塞治疗难治性鼻出血比较

A comparative study of endoscopic electrocoagulation hemostasis and local packing in treating refractory epistaxis

目的比较分析鼻内镜下电凝止血与局部填塞治疗难治性鼻出血的疗效。方法将垫江县人民医院收治的难治性鼻出血患者90例纳入研究对象,分为给予鼻内镜下电凝止血治疗的观察组和给予局部填塞治疗的对照组,观察两组患者的止血相关指标、术后负面情绪指标。结果观察组出血量(36.2±6.4)mL、止血时间(42.1±6.9)min、鼻腔黏膜恢复时间(3.4±0.7)d、鼻腔通气恢复时间(2.6±0.5)d、填塞后再次出血率(4.44%)、治疗后出现综合征反应率(15.56%)及黏膜变化率(13.33%)均明显低于对照;止血后3d时观察组患者汉密尔顿焦虑量表、汉密尔顿抑郁量表、焦虑自评量、抑郁自评量表、疼痛程度数字评价量表评分均明显低于对照组,差异均有统计学意义(P<0.05)。结论鼻内镜下电凝止血有助于改善止血效果、改善鼻腔功能、防止再出血发生、缓解负面情绪,具有积极的临床价值。

Objective To compare and analyze the effect of endoscopic electrocoagulation hemostasis and local packing in treating refractory epistaxis .Methods 90 cases of refractory epistaxis in our hospital were enrolled and randomly divided into the observation group reated by endoscopic electrocoagulation hemostasis and the control group treated only by local packing treatment .Then the hemostasis related indexes and postoperative negative emotion inde‐xes were observed in the two groups .Results In the observation group ,the bleeding volume was （36 .2 ± 6 .4）mL , hemostatic time was （42 .1 ± 6 .9）min ,nasal mucosa recovery time was （3 .4 ± 0 .7）d ,nasal ventilation recovery time was （2 .6 ± 0 .5）d ,rebleeding rate after packing was（4 .44% ） ,syndrome response occurrence rate after treatment was （15 .56% ） and mucosa change rate was （13 .33% ） ,which were significantly lower than thosein the control group;the NRS scores of HAMA and HAMD ,SAS and SDS at 3 h after hemostasis were significantly lower than those in the control group ,the differences were statistically significant （P〈0 .05） .Conclusion Endoscopic electrocoagulation he‐mostasis conduces to improve the hemostatic effect and nasal function ,prevent rebleeding ,alleviate negative emotions and possesses the active clinical value.