负压装置在定位隐匿性鼻出血部位中的临床应用

Clinical application of negative pressure device in localization of occulted epistaxis

目的 探讨负压装置定位隐匿性鼻出血部位的临床应用价值及安全性。方法 收集2018年8月-2021年7月该科收治的隐匿性鼻出血患者318例作为观察组,2015年8月-2018年7月该科收治的隐匿性鼻出血患者264例作为对照组。观察组嘱患者屏气后,应用负压吸引装置诱发鼻出血,然后应用鼻内镜检查定位出血部位。对照组行常规鼻内镜检查。两组患者的鼻腔出血部位均用可吸引电极电凝止血。回顾性分析两组患者鼻出血部位检出率、手术时间、住院时间、鼻出血复发例数、术中疼痛、术后鼻腔局部粘连例数和术后分泌性中耳炎患病例数。结果 观察组较对照组鼻出血检出率更高,手术时间和住院时间明显缩短,复发例数减少,术中疼痛明显减轻,术后鼻腔粘连例数减少,差异均有统计学意义(P <0.05)。且观察组未见非出血部位黏膜异常损伤,术后随访未出现分泌性中耳炎。结论 应用负压装置定位隐匿性出血部位治疗鼻出血安全有效,值得临床推广。

Objective To investigate the value and safety of the clinical application of negative pressure device to locate the site of occult epistaxis. Methods In this study, 318 patients with occult rhinorrhea from August 2018to July 2021 were retrospectively collected as the observation group, and 264 patients with occult rhinorrhea from August 2015 to July 2018 were used as the control group. In the observation group, patients were instructed to hold their breath and then apply a negative pressure suction device to induce nasal bleeding, and then apply nasal endoscopy to locate the bleeding site. In the control group, conventional nasal endoscopy was performed. The patients in both groups had their nasal bleeding sites stopped by electrocoagulation with an attractable electrode. The detection rate of nasal bleeding site, length of surgery, hospital stay, number of recurrent nasal bleeding cases,intraoperative pain, number of postoperative local adhesions in the nasal cavity, and number of postoperative cases of secretory otitis media were collected from both groups. Results The observation group had higher detection rate of nasal bleeding, significantly shorter operation length and hospital stay, fewer cases of recurrence, significantly less intraoperative pain, and fewer cases of postoperative nasal adhesions than the control group, and the differences were statistically significant(P < 0.05). In the observation group, no mucosal heterogeneous injury was seen at the non-bleeding site, and none of them had secretory otitis media at postoperative follow-up. Conclusion The application of negative pressure device to locate occult bleeding sites for the treatment of epistaxis is safe, effective,and worthy of clinical promotion.