鼻内镜下老年人鼻腔后部难治性出血的治疗

The endoscopic treatment of refractory hemorrhage in the posterior nasal cavity

目的:探讨老年人鼻腔后部难治性出血的鼻内镜下治疗疗效。方法:2016年1月～2017年12月期间我科收治146例老年鼻腔后部难治性出血的鼻内镜下处理患者,将鼻内镜下单极电凝止血治疗作为观察组,鼻内镜下鼻腔填塞治疗作为对照组,每组各73例,比较两组患者一次性治疗总有效率、并发症发生率、复发率、VAS评分和其对治疗的满意度。结果:两组患者一次性治疗总有效率差异比较均无统计学意义(P>0.05);两组患者均未见粘连和穿孔并发症及再次复发出血;观察组手术结束时和术后24 h VAS评分低于对照组,但对治疗的满意率却高于对照组,差异比较有统计学意义(P<0.05)。结论:鼻内镜下探查鼻腔后部的出血点具有重要意义;对出血部位进行准确电凝和对无法电凝部位行局部填塞,是成功的关键,且安全性和患者满意度也更受肯定。

Objective:To explore the effect of endoscopic nasal endoscopic treatment of refractory hemorrhage in the posterior nasal passages in the elderly.Methods:From Jan.2016 to Dec.2017,146 cases of senile posterior nasal cavity hemorrhage were under nasal endoscopic treatment in our hospital.They were divided into control group and observation group with 73 cases in each group.The control group was treated with endoscopic nasal packing for treatment,the observation group was treated by monopole electrocoagulation hemostasis under nasal endoscope.Then the effective rate,complication rate,recurrence rate,VAS score of one-off treatment and patient satisfaction with treatment were analyzed and compared.Results:The total effective rate had no statistical significance(P>0.05);the two groups of patients had no complication and no recurrence of bleeding;the observation group at the end of surgery and postoperative 24 h VAS score lower than the control group,patients satisfaction to treatment was higher than the control group,compared the difference was statistically significant(P<0.05).Conclusion:Explorating the bleeding point of posterior nasal under endoscopic has important significance;accurate monopoleelectrocoagulation and unable to electrocoagulation with local parts packing is the key to success,and the safety and satisfaction of patients were also more positive.