鼻内镜双极电凝止血结合微填塞治疗难治性鼻出血的效果分析

Effect Analysis of Nasal Endoscopy Bipolar Electrocoagulation Hemostasis Combined with Microtamponade in the Treatment of Refractory Epistaxis

目的:探讨鼻内镜双极电凝止血结合微填塞治疗难治性鼻出血的效果。方法:选择2020年3月—2022年5月厦门大学附属中山医院收治的难治性鼻出血患者80例为研究对象,依据随机抽签法,将纳入研究的患者分为对照组、研究组,各40例。对照组予以传统局部填塞治疗,研究组予以鼻内镜双极电凝止血结合微填塞治疗。比较两组临床治疗效果、应激反应指标、恢复情况及并发症发生情况。结果:研究组治疗总有效率为97.50%,高于对照组的77.50%,差异有统计学意义(P<0.05);治疗后1 d,研究组的皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)水平低于对照组,差异有统计学意义(P<0.05);研究组止血时间、鼻腔黏膜恢复时间、鼻腔恢复通气时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);研究组头痛、发热、鼻痛、鼻塞的并发症总发生率为20.00%,低于对照组的50.00%,差异有统计学意义(P<0.05)。结论:相比传统局部填塞治疗,鼻内镜双极电凝止血结合微填塞对难治性鼻出血患者应用价值更高,可提升治疗效果,改善患者应激反应指标及恢复情况,减少并发症的发生。

Objective:To explore the effect of nasal endoscopy bipolar electrocoagulation hemostasis combined with microtamponade in the treatment of refractory epistaxis.Method:A total of 80 patients with refractory epistaxis admitted to Zhongshan Hospital Xiamen University from March 2020 to May 2022 were selected as the study objects.According to the random drawing method,they were divided into control group and study group,with 40 patients in each group.The control group received traditional local tamponade treatment,while the study group received nasal endoscopy bipolar electrocoagulation hemostasis combined with microtamponade treatment.The clinical treatment efficacy,stress response indicators,recovery status and incidence of complications between the two groups were compared.Result:The total effective rate of the study group was 97.50%,which was higher than 77.50%in the control group,the difference was statistically significant(P<0.05).At 1 d after treatment,the levels of cortisol(Cor),norepinephrine(NE),and epinephrine(E)in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The hemostasis time,nasal mucosal recovery time,and nasal ventilation recovery time of the study group were shorter than those of the control group,and the intraoperative bleeding volume was less than that of the control group,the differences were statistically significant(P<0.05).The total incidence of complications such as headache,fever,nasal pain,and nasal congestion in the study group was 20.00%,which was lower than 50.00%in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with traditional local tamponade therapy,the combination of nasal endoscopy bipolar electrocoagulation hemostasis and microtamponade has higher application value for patients with refractory epistaxis,which can improve treatment effectiveness,improve stress response indicators and recovery,and reduce the occurrence of complications.