鼻内镜下超声刀治疗鼻出血的疗效观察

Effect observation of ultrasonic scalpel through rhinoscope in the treatment of epistaxis

目的 探讨鼻内镜下用超声刀治疗鼻出血的可行性和价值.方法 前瞻性分析2013年3月至2015年3月我院行鼻内镜下鼻出血微创治疗的患者60例,按手术方式分为三组：超声刀治疗组、射频治疗组及等离子刀治疗组,每组20例.对比分析三组患者的手术时间、术中出血量及术后疼痛评分.结果 超声刀组的手术时间、术中出血量均低于射频治疗组及等离子刀组,且差异有统计学意义（P＜0.05）.与射频治疗组相比,超声刀组术后6h、24 h、72 h的疼痛评分更低（P＜0.05）;超声刀组术后6h的疼痛评分低于等离子刀组（P＜0.05）,但术后24 h、72 h的疼痛评分两组差异无统计学意义（P＞0.05）.三组患者的平均疼痛时间无统计学差异（P＞0.05）.结论 超声刀可用于鼻出血的治疗,其优点是出血少、手术时间短、术后疼痛较轻,有较好的临床应用及推广价值.

Objective To investigate the feasibility and efficacy of ultrasonic scalpel through rhinoscope in the treatment of epistaxis.Methods 60 cases of epistaxis in our hospital from March 2013 to March 2015 were randomly divided into 3 groups,20 cases in each group,underwent endoscopic hemostasis by ultrasonic scalpel （US）,radiofrequency （RF） and plasma knife （PK） respectively.Operative time,the amount of bleeding and postoperative pain score of three groups were compared.Results Operative time,the amount of bleeding in US group were less than those in RF group and PK group （P＜0.05）.Pain score in US group 6 h,24 h,72 h after operation were lower than those in RF group;pain score in US group 6 h after operation was lower than that in PK group （P＜0.05）,while there were no statistically significant differences in pain score 24 h,72 h after operation between two groups （P＞0.05）.There was no statistically significant difference in the average pain time among three groups （P＞0.05）.Conclusions Ultrasonic scalpel can be applied in epistaxis treatment with the advantages of less bleeding,shorter operative time,and slight postoperative pain,worthy of clinical application and promotion.