湿润烧伤膏联合双极电凝止血术治疗鼻出血的疗效及其对疼痛、创面愈合和并发症的影响

Efficacy of moisture exposed burn ointment combined with bipolar electrocoagulation in the treatment of epistaxis and its effect on pain,wound healing and complications

目的探究湿润烧伤膏联合双极电凝止血术治疗鼻出血的疗效及其对疼痛、创面愈合和并发症的影响。方法前瞻性选取2022年6月至2023年12月秦皇岛市第一医院收治的100例鼻出血患者为研究对象,按照随机数字表法将其分为对照组和观察组,每组各50例。对照组行双极电凝止血术治疗,观察组行湿润烧伤膏联合双极电凝止血术治疗。比较两组临床疗效,术后30 min、2 h、6 h、24 h的疼痛情况[视觉模拟评分法(VAS)]、术后一般情况(术后72 h内鼻腔总出血量、鼻腔恢复通气时间及复发)、创面愈合时间、并发症发生情况。结果观察组临床总有效率为96.00%,高于对照组(84.00%),差异有统计学意义(P<0.05)。观察组术后30 min、2 h、6 h、24 h的VAS评分分别为(4.38±1.25)、(3.86±1.13)、(2.89±0.78)、(1.35±0.62)分,均低于对照组[(5.78±1.62)、(4.43±1.04)、(3.63±0.95)、(2.18±0.73)分],差异均有统计学意义(P<0.05)。观察组术后72 h内鼻腔总出血量为(17.58±4.93)mL,少于对照组[(22.31±5.65)mL],鼻腔恢复通气时间为(3.15±0.54)d,短于对照组[(3.40±0.61)d],差异均有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05)。观察组创面愈合时间为(6.74±1.02)d,短于对照组[(9.82±0.97)d],差异有统计学意义(P<0.05)。观察组并发症总发生率为6.00%,低于对照组(20.00%),差异有统计学意义(P<0.05)。结论加用湿润烧伤膏可明显提高双极电凝止血术治疗鼻出血的临床疗效,减少术后出血量,缓解疼痛,促进创面愈合,并可减少并发症的发生。

Objective To explore the efficacy of moisture exposed burn ointment combined with bipolar electrocoagulation in the treatment of nasal bleeding and its effects on pain,wound healing and complications.Methods A total of 100 patients with nasal bleeding admitted to the First Hospital of Qinhuangdao from June 2022 to December 2023 were prospectively selected,and divided into the control group and the observation group according to the random number table method,with 50 cases in each group.The control group was treated with bipolar electrocoagulation hemostasis,and the observation group was treated with moisture exposed burn ointment combined with bipolar electrocoagulation hemostasis.The clinical efficacy,pain[visual analogue scale(VAS)]at 30 min,2 h,6 h and 24 h after operation,general postoperative conditions(total nasal bleeding within 72 h after operation,nasal ventilation recovery time,and recurrence),wound healing time,and complications were compared between the two groups.Results The total effective rate of the observation group was 96.00%,which was higher than that of the control group(84.00%),the difference was statistically significant(P<0.05).The VAS scores of the observation group at 30 min,2 h,6 h and 24 h after operation were(4.38±1.25),(3.86±1.13),(2.89±0.78)and(1.35±0.62)points,respectively,which were lower than those of the control group[(5.78±1.62),(4.43±1.04),(3.63±0.95)and(2.18±0.73)points],and the differences were statistically significant(P<0.05).The total amount of nasal bleeding within 72 h after operation in the observation group was(17.58±4.93)mL,which was less than that in the control group[(22.31±5.65)mL],and the time of nasal ventilation recovery was(3.15±0.54)d,which was shorter than that in the control group[(3.40±0.61)d],the differences were statistically significant(P<0.05).There was no statistically significant difference in recurrence rate between the two groups(P>0.05).The wound healing time of the observation group was(6.74±1.02)d,which was shorter than that of the control group[(9.82±0.97)d],and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was 6.00%,which was lower than that in the control group(20.00%),and the difference was statistically significant(P<0.05).Conclusion The application of moisture exposed burn ointment can significantly improve the clinical efficacy of bipolar coagulation hemostasis in the treatment of epistaxis,reduce the amount of postoperative bleeding,relieve pain,promote wound healing,and reduce the occurrence of complications.