鼻内镜下彭氏电刀治疗难治性鼻出血的疗效观察

Curative effect analysis of Peng’s electric knife under nasal endoscope on intractable epistaxis

目的探讨鼻内镜下彭氏电刀电凝治疗难治性鼻出血的方法及疗效。方法回顾性分析2013年12月~2017年12月因难治性鼻出血住院并行鼻内镜检查明确鼻出血的患者120例,均采用鼻内镜监视下彭氏电刀电凝止血,结合明胶海绵局部微填塞,术后随诊3个月,观察治疗效果。结果一次性治愈80例,二次治愈16例,6例因鼻中隔重度偏曲,经行鼻中隔成形术后治愈,所有患者均无心脑血管意外、鼻中隔穿孔、鼻腔粘连等并发症发生。结论鼻内镜检查能准确查找难治性鼻出血的出血部位,鼻内镜辅助下彭氏电刀电凝治疗鼻出血疗效确切,安全有效,其治愈率高,并发症少,患者痛苦小,尤其适用于有全身疾病的老年患者,值得临床推广。

Objective To explore the method and effect of Peng’s electrocoagulation under nasal endoscope in the treatment of intractable epistaxis.Methods A retrospective analysis was performed on 120 patients with intractable epistaxis confirmed by nasal endoscopy, and admitted to the hospital from December 2013 to December 2017. All the 120 patients underwent electrocoagulation and hemostasis with peng’s electric knife under nasal endoscopic surveillance, combined with local microtamponade with gelatin sponge. The therapeutic effect was observed by postoperative follow up of 3 months.Results 80 cases were cured after once treatment, 16 cases were cured after twice treatment, and 6 cases were cured after nasal septum plasty due to severe deviation of nasal septum. All patients had not complications such as cardio-cerebrovascular accident, perforation of nasal septum and nasal adhesion.Conclusion Nasal endoscopy examination can accurately locate the bleeding site of refractory epistaxis. Peng’s electrocoagulation assisted by nasal endoscopy is effective and safe in the treatment of epistaxis. It has a high cure rate, fewer complications and less pain, especially suitable for elderly patients with systemic diseases. It is worthy of clinical promotion.