鼻内镜下鼻止血术后再出血的鼻内镜处理

Clinical therapy for re-bleeding after endoscopic sinus hemostasis

目的:探讨鼻内镜下鼻止血术后再次出血的鼻内镜下处理技巧及疗效。方法:回顾性分析2014年1月至2021年1月符合入选标准的我科住院行鼻内镜鼻止血术后再出血患者的临床资料。随访3个月,分析患者出血高危因素,观察再次鼻内镜下鼻止血效果,总结技术要点。结果:共入选53例鼻内镜下鼻止血术后再出血患者,年龄31~79岁,平均58.6岁。女性10例(18.87%),男性43例(81.13%)。再出血发生于首次鼻内镜下止血后0.5 h~0 d。其中,出血发生于24 h内25例(47.18%),24~72 h 12例(22.64%),72 h~7 d 8例(15.09%),7~30 d 8例(15.09%)。患者均再次接受经鼻内镜下鼻止血术,术后即刻止血成功率100%,术后随访3个月2例发生间断少量出血,对症治疗后出血停止,其余患者未再有活动性出血。结论:鼻内镜下鼻止血术后再出血采用鼻内镜再次处理有效。

Objective:To explore the technique and curative effect of nasal endoscopic treatment for re-bleeding after nasal hemostasis.Methods:Clinical data of patients with rebleeding after nasal endoscopic nasal hemostasis in otolaryngology head and neck surgery department of the People’hospital of Rugao from January 2014 to January 2021 who met the selection criteria To retrospectively analyze the.Follow-up for 3 months,the high risk factors for bleeding was analyzed,the effect of nasal hemostasis under nasal endoscopy was observed,and the technical points were summarized.Results:A total of 53 patients with rebleeding after nasal hemostasis under nasal endoscopy were enrolled,aged from 31 to 79 years old,with an average age of 58.6 years,including 10 females(18.87%)and 43 males(81.13%).Rebleeding occurred 0.5 h-30 d after the first hemostasis under nasal endoscopy.Among them,bleeding occurred within 24 h in 25 cases(47.18%),24-72 h in 12 cases(22.64%),72 h-7 d in 8 cases(15.09%),and 7-30 d in 8 cases(15.09%).All patients underwent nasal hemostasis under nasal endoscopy again.The success rate of immediate hemostasis was 100%.A small amount of bleeding occurred in 2 cases after 3 months of follow-up.The bleeding stopped after treatment,and no active bleeding occurred in the rest of the patients.Conclusions:Re-bleeding after nasal hemostasis under nasal endoscopy can be effectively treated with nasal endoscopy.