|本期目录/Table of Contents|

[1]管琴,雷家欢,江满杰.鼻内镜治疗难治性鼻出血的疗效分析[J].医学研究与战创伤救治(原医学研究生学报),2016,18(05):493-495.[doi:10.3969/j.issn.1672-271X.2016.05.013]
　GUAN Qin,LEI Jia-huan,JIANG Man-jie.Electric coagulation hemostasis under nasal endoscope for treatment of intractable epistaxis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(05):493-495.[doi:10.3969/j.issn.1672-271X.2016.05.013]
点击复制

鼻内镜治疗难治性鼻出血的疗效分析()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第18卷
期数:
2016年05期
页码:
493-495
栏目:
出版日期:
2016-09-20

文章信息/Info

Title:
Electric coagulation hemostasis under nasal endoscope for treatment of intractable epistaxis
作者:
管琴1; 雷家欢1; 江满杰2
1. 211131江苏南京，南京军区南京总医院汤山疗养院耳鼻咽喉-头颈外科；2. 210002江苏南京，南京军区南京总医院耳鼻咽喉-头颈外科
Author(s):
GUAN Qin1;  LEI Jia-huan1;  JIANG Man-jie2
1.Tangshan Sanatorium, Nanjing General Hospital of Nanjing Military Command, Nanjing, Jiangsu 211131, China;2.Department of Otolaryngology, Nanjing General Hospital of Nanjing Military Command, PLA, Nanjing, Jiangsu 210002, China
关键词:
难治性鼻出血; 鼻内镜; 电凝
Keywords:
intractable epistaxis;  nasal endoscope;  electric coagulation
分类号:
R765.23
DOI:
10.3969/j.issn.1672-271X.2016.05.013
文献标志码:
A
摘要:
目的 分析鼻内镜治疗难治性鼻出血的疗效，与传统的填塞止血方法 比较。方法 回顾性分析2013年1月-2014年12月接受治疗的鼻出血患者79例的临床资料。比较鼻内镜止血组（61例）与鼻腔填塞止血组（18例）的治疗效果、疼痛程度、再出血（治疗后至随访4周结束）、出血量（治疗开始至随访4周结束）、术后鼻腔恢复通气时间等。结果 鼻内镜组患者治愈率为91.8%，高于鼻腔填塞组（72.2%）。术后4周内鼻内镜组患者再出血率为6.5%，低于鼻腔填塞组38.9%。治疗中鼻内镜组患者疼痛评分平均值为（3.11±2.72），与鼻腔填塞组(3.74±1.49)比较，差异无统计学意义(P＞0.05），治疗后疼痛评分平均值(1.59±0.48)低于鼻腔填塞组(3.43±1.37)。鼻内镜组总出血量(31.05±12.83) mL低于鼻腔内填塞组（51.09±18.32）mL。鼻内镜组术后主观鼻腔恢复通气时间(3.1±1.8)d短于鼻腔填塞组（6.4±1.8）d。以上各项指标两组比较，除治疗中患者疼痛评分平均值外，其他指标差异均有有统计学意义(P＜0.01）。结论 鼻内镜下电凝止血术操作出血点位置准确，疗效可靠，出血量少，疼痛较轻，术后恢复较快，可作为难治性鼻出血的首选治疗方法 。
Abstract:
Objective To study the clinical effect of electric coagulation hemostasis under nasal endoscope for treatment of intractable epistaxis and compared with traditional packing hemostasis method. Methods Clinical data of intractable epistaxis patients received treatment at our hospital from Jun 2013 to Dec 2014 were retrospectively analyzed. Patients were divided into two groups. Group A (total 61 patients) received nasal endoscope treatment; Group B (total 18 patients) received packing hemostasis treatment. Cure rate, pain scale, nosal ventilation function of recovery and rehaemorrhagia rate were compared between the two groups. Results Group A had a higher cure rate than Group B, and the difference was statistically significant (91.8% vs 72.2%, P<0.01); The pain scales were lower in Group A in post-treatment time than Group B, and the difference was statistically significant (1.59±0.48 vs 3.43±1.37,P<0.01), while this difference was not statistically significant in treatment time (3.11±2.72 vs 3.74±1.49, P＞0.05); The amount of bleeding was lower in Group A than in Group B, and the difference was statistically significant(31.05±12.83 vs 51.09±18.32, P<0.01); Group A had a lower rehaemorrhagia rate than Group B, and the difference was statistically significant (6.5% vs 38.9%, P<0.01); The Group A had a sooner ventilation function of recovery than Group B, and the difference was statistically significant (3.1±1.8 vs 6.5±1.8, P<0.01). Conclusion Electric coagulation hemostasis under nasal endoscope is a safe and effective treatment for intractable nosebleed.

参考文献/References:

[1]黄杰，陈丽，高莉莉．鼻腔鼻窦内翻性乳头状瘤48例[J].东南国防医药,2011，13（1）：40-41.
[2]赵学林.心理干预在老年性鼻出血治疗中的作用[J].贵阳中医学院学报,2015，37（6）：58-59.
[3]郭丽敏，王德辉．顽固性鼻出血的诊疗策略探讨[J]. 中国眼耳鼻喉科杂志，2015,15(2):115-117.
[4]曹爽,朱红.经鼻内镜脑膜脑膨出切除与修补术1例护理[J].医学研究生学报,2011,24(4):447-448.
[5]郝晓霞，李育玲，李晓．难治性鼻出血的舒适护理[J].护理研究,2013，27(10):3415-3416.
[6]王俊国，钱晓云，王涵东，等.鼻内镜下电凝结合微填塞治疗难治性鼻出血[J].现代生物医学进展,2015，115（35）：6896-6899.
[7]李惠，孙珍龙，吴俊，等.膨胀海绵外套胶皮在鼻腔填塞中的应用[J]. 中国耳鼻咽喉头颈外科,2014,21(12):657-659.
[8]李海洲，那学武，朱丽明，等.鼻出血部位及原因的研究和鼻内镜下治疗体会[J]. 临床耳鼻咽喉头颈外科杂志, 2014,28(20):1608-1610.
[9]黄杰，陈丽.鼻内镜鼻窦手术中中鼻甲的处理[J].东南国防医药,2004,6(6):423-424.
[10]古庆家，李静娴，樊建刚，等.鼻内镜下治疗顽固性鼻出血64例临床分析[J].临床耳鼻喉科头颈外科杂志,2014，28(3):198-200.
[11]施祝良，张学渊，黄洁．术后鼻黏膜组织嗜酸性粒细胞阳离子蛋白及趋化因子的变化[J].东南国防医药，2011，13(5):419-421.
[12]吴晶,罗伟,王天友,等.可乐定对鼻内镜术中小剂量肾上腺素浸润注射所致低血压的影响[J].医学研究生学报,2011,24(8):840-842.
[13]黄辉，柴伟，何苗，等．鼻内镜双极电凝烧灼治疗老年难治性鼻出血的有效性与安全性研究[J].中国地方防治疗杂志,2015，30(6):478-480.

相似文献/References:

[1]黄 杰,陈 丽,高莉莉.鼻腔鼻窦内翻性乳头状瘤48例[J].医学研究与战创伤救治(原医学研究生学报),2011,13(01):40.
　HUANG Jie,CHEN Li,GAO Li-li.Clinical analysis of 48 case with nasal cavity and paranasal sinuses inverted papilloma[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(05):40.
[2]季俊峰,陈伟,程友,等.经鼻内镜泪前隐窝进路上颌窦病变切除疗效分析[J].医学研究与战创伤救治(原医学研究生学报),2020,22(6):608.[doi:10.3969/j.issn.1672-271X.2020.06.011]
　JI Jun-feng,CHEN Wei,CHENG You,et al.Analysis of the efficacy of endoscopic resection of maxillary sinus lesions by prelacrimal recess approach[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(05):608.[doi:10.3969/j.issn.1672-271X.2020.06.011]

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2016-12-09