全麻下鼻内镜治疗顽固性鼻出血的临床观察

摘要

Objective To sum up the therapeutic effect of nasal endoscopic hemostasis on refractory epistaxis under general anesthesia based on a clinical analysis. Methods A retrospective analysis was made among 138 patients with refractory epistaxis treated in our Hospital. They were all treated by the procedure of nasal endoscopic hemostasis under general anesthesia. Then, a following up period lasted for 3 months was carried out among them to observe the therapeutic effect of such a procedure among them. Results Among these 138 cases, 120 (87%) were cured successfully by either electrocautery or radiofrequency procedures following exact identification of bleeding location, 12 with severe nasal septum deviation were successfully cured following nasal septum correction surgery to find the hindered bleeding location. In another 6 cases with no exact bleeding location found, bleeding was stopped by iodoform gauze packing into nasal cavity in 4 cases, and stopped in the other 2 by interventional embolization via maxillary artery in other way following invalid nasal packing. The total effective rate was 95.7% in this group of cases. Conclusion The procedure of nasal endoscopic hemostasis under general anesthesia is an effective strategy to treat refractory epistaxis, with less painful feeling during the operation.%目的：总结全麻下鼻内镜治疗顽固性鼻出血的临床疗效。方法回顾性分析我院收治的138例顽固性鼻出血患者，均采用全麻下鼻内镜止血治疗，然后随访3月，观察疗效。结果138例患者中，120例（87%）找到了确切出血点，经电凝或射频止血治疗成功；12例因鼻中隔Ⅲ度偏曲影响鼻内镜检查及治疗，改行鼻中隔矫正术后止血成功；6例未发现明确出血点患者行碘仿纱条填塞，4例止血成功，2例行上颌动脉栓塞后止血成功。总有效率95.7%。结论全麻下鼻内镜止血，能够有效治疗顽固性鼻出血。