鼻内镜双极电凝止血对老年难治性鼻出血患者临床症状及应激反应的影响

The impact of nasal endoscopy bipolar electrocoagulation hemostasis on clinical symptoms and stress response in elderly patients with intractable epistaxis

目的探讨鼻内镜双极电凝止血对老年难治性鼻出血患者临床症状及应激反应的影响,分析其可能作用机制。方法选择2015年7月至2016年12月收治的老年难治性鼻出血患者112例,根据病历单双号随机分为观察组和对照组各56例。对照组给予凡士林纱条堵塞治疗,观察组联合应用鼻内镜双极电凝止血治疗,比较两组临床症状、应激反应、复发率与并发症等指标。结果观察组有效率96.43%明显高于对照组82.14%(P<0.05);出血量、止血时间、鼻腔恢复通气时间、鼻腔黏膜恢复时间均明显小于对照组(P<0.01);血清去甲肾上腺素、肾上腺素、皮质醇含量均明显低于对照组;复发率、并发症均明显低于对照组,差异有统计学意义(P<0.05)。结论鼻内镜双极电凝止血有助于改善老年难治性鼻出血患者临床症状,缓解应激反应,降低复发率与并发症,提高治疗效果。

Objective To investigate the effect of nasal endoscopy bipolar electrocoagulation hemostasis on clinical symptoms and stress response in elderly patients with intractable epistaxis,and analyze the possible mechanisms. Methods One hundred and twelve elderly patients with intractable epistaxis treated in our hospital from July 2015 to December 2016 were randomly divided into observation group and control group according to odd or even number of medical records.The control group was given vaseline gauze plugging therapy while the observation group was treated with nasal endoscopy bipolar electrocoagulation hemostasis. Clinical symptoms,stress reaction,recurrence rate and complication were compared between the two groups.Results The effective rate in the observation group was 96. 43% that was significantly higher than that in the control group（ 82. 14%,P〈0. 05）. The bleeding volume,hemostasis time,nasal recovery time and mucous membrane recovery time in the observation group were significantly less or shorter than those in the control group（ P〈0. 01）. Serum levels of norepinephrine,adrenaline and cortisol in the observation group were significantly lower than those in the control group.The recurrence rate and complication in the observation group were significantly lower than those in the control group.All differences were statistically significant（ P〈0. 05）.Conclusion Nasal endoscopy bipolar electrocoagulation hemostasis can help to improve the clinical symptoms,alleviate the stress reaction,reduce the recurrence rate and complication and improve the therapy effect.