难治性鼻出血患者行鼻内镜下双极电凝止血治疗的疗效观察

Curative Effect of Bipolar Electrocoagulation Hemostasis Under Nasal Endoscope in Patients with Refractory Epistaxis

目的:研究难治性鼻出血患者行鼻内镜双极电凝止血治疗的效果。方法:数据遴选本院2019年8月~2021年8月收治的70例难治性鼻出血患者,采用随机抽样法分为纱条组(凡士林纱条填塞,n=35)、电凝组(鼻内镜双极电凝止血,n=35),对比两组患者的氧化应激反应指标(血清皮质醇、去甲肾上腺素、肾上腺素)以及两组患者的临床指标、治疗效果。结果:治疗前两组Cor、NA、E等氧化应激反应指标水平比较无统计学意义(P>0.05);治疗后两组Cor、NA、E水平均升高,并且电凝组升高幅度大于纱条组升高幅度,差异均具有统计学意义(P<0.05);电凝组出血量更少,止血、鼻腔通气及鼻腔黏膜恢复时间均短于或少于纱条组相应指标,差异具有统计学意义(P<0.05);电凝组患者的治疗有效率为97.14%,纱条组患者的治疗有效率为80.00%,电凝组患者的治疗有效率高于纱条组患者的治疗有效率,差异具有统计学意义(P<0.05)。结论:鼻内镜双极电凝止血治疗难治性鼻出血可改善应激反应、减少出血量,提高疗效。

Objective: To study the effect of bipolar electrocoagulation hemostasis under nasal endoscope on refractory epistaxis. Methods: 70 patients with refractory epistaxis treated in our hospital from August 2019 to August 2021 were selected. According to the random sampling method, they were divided into gauze group(vaseline gauze packing, n=35) and electrocoagulation group(nasal endoscopy bipolar electrocoagulation hemostasis, n=35). The clinical effects of the two groups were compared. Results: There was no significant difference in the levels of Cor, NA, E and other oxidative stress indexes between the two groups before treatment(P>0.05). After treatment, the levels of Cor, NA, E in the two groups increased, and the increase in the electrocoagulation group was greater than that in the gauze group, the difference was statistically significant(P<0.05). The bleeding volume was less in the electrocoagulation group, and the hemostasis, nasal ventilation and nasal mucosal recovery time were shorter or less than the corresponding indexes in the gauze group(P<0.05). The effective rate of electrocoagulation group was 97.14%, and that of gauze group was 80.00%. The effective rate of electrocoagulation group was higher than that of gauze group(P<0.05). Conclusion: Bipolar electrocoagulation hemostasis under nasal endoscope in patients with refractory epistaxis can improve stress response, reduce bleeding volume and improve curative effect.