鼻内镜下蝶腭动脉电凝术治疗顽固性鼻出血效果分析.docVIP

鼻内镜下蝶腭动脉电凝术治疗顽固性鼻出血效果分析 　　[摘要]目的 探讨鼻内镜下蝶腭动脉电凝术在顽固性鼻出血患者中的应用效果。方法 选取2012年6月～2015年5月我院耳鼻喉科收治的102例顽固性鼻出血患者，按治疗方法的不同分为A组（56例）和B组（46例）。A组采用出血点电凝加纱布填塞，B组采用鼻内镜下蝶腭动脉电凝术治疗，比较两组患者的止血时间、止血成功率、复发率、术后通气功能及嗅觉功能以及发症发生率。结果 B组患者的止血时间短于A组，差异有统计学意义（P0.05），B组术后的鼻腔嗅觉功能评分、鼻通气总阻力低于A组，差异有统计学意义（P0.05）。结论 鼻内镜下蝶腭动脉电凝术治疗顽固性鼻出血的效果肯定，止血彻底，成功率高，值得临床推广应用。 　　[关键词]鼻内镜；蝶腭动脉；电凝；顽固性鼻出血 　　[中图分类号] R765.23 [文献标识码] A [文章编号] 1674-4721（2017）11（b）-0096-04 　　[Abstract]Objective To explore the application effect of diathermy of the sphenopalatine artery under nasal endoscope in the treatment of intractable epistaxis.Methods From June 2012 and May 2015，102 patients with intractable epistaxis treated in our department were selected.According to different therapeutic methods，they were divided into group A （56 cases） and group B （46 cases）.Patients in group A were treated by diathermy combined with gauze packing，Patients in group B were treated by diathermy of the sphenopalatine artery under nasal endoscope.The hemostasis time，success rate of hemostasis，recurrence rate，postoperative ventilation function，olfactory function，and the incidence rate of complications were compared between the two groups.Results The hemostasis time in group B was shorter than that in group A，with significant difference （P0.05）.The postoperative nasal olfactory function score，the total resistance of nasal ventilation in group B was lower than that in group A，with significant difference （P0.05）.Conclusion Diathermy of the sphenopalatine artery under nasal endoscope in the treatment of intractable epistaxis is definite，which can completely stanch bleeding，with high success rate，it is worthy of clinical application and promotion. 　　[Key words]Nasal endoscope；Sphenopalatine artery；Diathermy；Intractable epistaxis 　　鼻出血是耳鼻喉科?^为常见的疾病之一，其中顽固性鼻出血则是较为棘手的问题。由于出血点难以在短时间内准确找出，造成止血不及时，疗效不满意[1]。关于顽固性鼻出血，以往多认为出血来源于鼻中隔后段或鼻腔后部的Woodruff静脉丛，治疗方法多为后鼻孔填塞，严重者则给予颈外动脉或筛前动脉结扎，患者痛苦较大，且疗效并不确切[2]。随着近年来对顽固性鼻出血研究的不断深入，关于其出血血管的认识有了改变，目前认为蝶腭动脉主干或其分支血管出血是导致顽固性鼻出血的重要