鼻内镜下双极电凝止血与常规填塞止血对顽固性鼻出血患者鼻腔再出血风险的影响

Effect of Bipolar Electrohemostasis Under Nasal Endoscopy and Routine Tamponade Hemostasis on the Risk of Nasal Rebleeding in Patients with Intractable Epistaxis

目的 探讨鼻内镜下双极电凝止血与常规填塞止血对顽固性鼻出血患者鼻腔再出血风险的影响。方法 回顾性分析2020年1月—2022年6月收治的98例顽固性鼻出血作为研究对象,按照治疗方法不同分为观察组和对照组,每组49例。观察组采用鼻内镜下双极电凝止血治疗,对照组采用常规填塞止血治疗。观察2组临床疗效及围术期指标,同时分析治疗后3 d鼻通气阻力、血小板(PLT)、血红蛋白(Hb)水平及再出血率。结果 观察组临床总有效率为97.96%(48/49)高于对照组的85.71%(42/49)(P<0.05)。观察组术中失血量少于对照组,止血时间、鼻腔通气恢复时间、鼻腔黏膜恢复时间均短于对照组(P<0.01)。治疗后,观察组单侧吸气阻力及呼气阻力、双侧吸气总阻力及呼气总阻力均低于对照组,PLT、Hb水平高于对照组(P<0.05)。观察组再出血率及并发症总发生率低于对照组(P<0.05)。结论 鼻内镜下双极电凝止血能提高顽固性鼻出血患者的临床疗效,促进患者恢复,提高鼻通气功能,降低再出血并发症发生风险,安全性较高。

Objective To investigate the effect of bipolar electrohemostasis under nasal endoscope and routine tamponade hemostasis on the risk of nasal rebleeding in patients with intractable epistaxis.Methods A total of 98 patients with intractable epistaxis treated from January 2020 to June 2022 were retrospectively analyzed as the research subjects and divided into observation group(n=49)and control group(n=49)according to different treatment methods.The observation group was treated with bipolar electrohemostasis under nasal endoscope,and the control group was treated with routine tamponade hemostasis.The clinical efficacy and perioperative indexes of the two groups were observed,and nasal ventilation resistance,platelet(PLT),hemoglobin(Hb)levels and rebleeding rate were analyzed at 3 d after treatment.Results The total effective rate of the observation group was 97.96%(48/49),which was higher than that of the control group[85.71%(42/49)](P<0.05).The intraoperative blood loss in the observation group was less than that in the control group,and the hemostasis time,nasal ventilation recovery time and nasal mucosa recovery time were shorter than those in the control group(P<0.01).After treatment,unilateral inspiratory resistance and expiratory resistance,bilateral total inspiratory resistance and total expiratory resistance in observation group were lower than those in control group,while PLT and Hb levels were higher than those in control group(P<0.05).The rebleeding rate and complication rate of the observation group were lower than those of the control group(P<0.05).Conclusion Bipolar electrohemostasis under nasal endoscopy can improve the clinical efficacy of patients with intractable epistaxis,promote patient recovery,improve nasal ventilation function,reduce the risk of rebleeding and complications,and have good safety.