鼻内窥镜下消融电极治疗鼻出血的临床分析

黄方名; 李中文; 李东海

doi:10.16766/j.cnki.issn.1674-4152.002002

鼻内窥镜下消融电极治疗鼻出血的临床分析

doi: 10.16766/j.cnki.issn.1674-4152.002002

1.
蚌埠市第三人民医院耳鼻喉科，安徽蚌埠 233000
2.
蚌埠医学院生物科学系，安徽蚌埠 233000

基金项目:

安徽高校自然科学研究重点项目 KJ2018A1004

详细信息

通讯作者:
李中文, E-mail: 279437606@qq.com

中图分类号: R765.23
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- 文章访问数: 204
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- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2020-11-04
- 网络出版日期: 2022-02-16

Clinical analysis of endoscopic ablation electrode in the treatment of epistaxis

1.
Department of Otolaryngology, the Third People's Hospital of Bengbu City, Bengbu, Anhui 233000, China

摘要

摘要: 目的探讨临床常见耳鼻喉科疾病鼻出血的治疗方法，了解鼻内窥镜下消融电极止血在临床治疗中的疗效，为进一步临床治疗提供依据。方法选择蚌埠市第三人民医院耳鼻喉科2016年1月—2019年12月收治的患者60例，收住标准为门诊鼻出血患者因出血量较大且未能发现明显出血位置且鼻腔填塞效果不佳，均排除鼻腔本身疾患以及全身疾患导致的鼻出血。按照患者或者患者家属意愿原则纳入研究，分为治疗组(消融电极组)及对照组(双极电凝组)，比较2组患者止血疗效、术后并发症情况、鼻腔伪膜脱落时间及鼻腔黏膜恢复时间，分析两者临床效果。结果消融电极组术后止血有效率达93.3%，高于对照组(83.3%)。术后，治疗组8例患者出现并发症，对照组21例患者出现并发症，2组比较差异有统计学意义(P＜0.05)。术后鼻腔伪膜脱落时间，治疗组为(4.64±0.66)d，对照组为(6.34±0.78)d；鼻腔黏膜恢复时间，治疗组为(6.66±0.53)d，对照组为(9.47±0.86)d，治疗组均低于对照组(均P＜0.05)。结论消融电极止血术在促进控制鼻出血及减少并发症的发生和促进鼻腔黏膜功能恢复方面明显优于双极电凝止血，促进鼻腔功能的恢复。
- 鼻出血 /
- 消融电极止血 /
- 双极电凝止血 /
- 疗效 /
- 并发症
Abstract: Objective To explore the new treatment of epistaxis, and to understand the effect of endoscopic ablation electrode haemostasis in clinical treatment, so as to provide basis for further clinical treatment. Methods Sixty patients admitted at the Department of Otolaryngology of the Third People's Hospital of Bengbu from January 2016 to December 2019 were selected. The inclusion criteria of outpatients with epistaxis included large amount of epistaxis, no obvious position of epistaxis and ineffective nasal packing. All patients were excluded from nasal diseases and epistaxis caused by systemic diseases. The patients were randomly divided into two groups to compare the haemostatic effect, postoperative complications, time of nasal mucosa loss and time of nasal mucosa recovery. Results The effective rate of haemostasis in the ablation electrode group was 93.3%, which was higher than that in the control group (83.3%). The treatment group had 8 cases of postoperative complications, which was significantly lower than that of the control group (21 cases). The time of pseudomembrane loss in the treatment group was (4.64±0.66) days, which was lower than that in the control group[(6.34±0.78) days]. The recovery time of nasal mucosa in the treatment group was (6.66±0.53) days, which was lower than that in the control group[(9.47±0.86) days]. The difference was statistically significant (all P < 0.05). Conclusion Ablative electrode haemostasis was superior to bipolar electrocoagulation in controlling epistaxis, reducing complications and promoting functional recovery of nasal mucosa.
- Epistaxis /
- Ablation electrode haemostasis /
- Bipolar coagulation haemostasis /
- Efficacy /
- Complication

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表 1 2组鼻出血患者止血效果比较[例(%)]

组别	例数	痊愈	有效	无效	总有效
治疗组	30	24(80.0)	4 (13.3)	2 (6.7)	28(93.3)
对照组	30	14(46.7)	11(36.6)	5 (16.7)	25(83.3)
注：2组总有效率比较，χ²=4.403，P=0.044。

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表 2 2组鼻出血患者术后并发症情况比较(例)

组别	例数	术后鼻腔粘连	鼻腔干燥感	嗅觉减退	中隔软骨坏死	其他	合计
治疗组	30	3	2	2	0	1	8
对照组	30	7	8	3	1	2	21
注：2组并发症总发生率比较，χ²=11.091，P＜0.001；其他主要指术后出现无明确病因的头痛和鼻腔堵塞感(而鼻腔检查未发现明显堵塞因素，鼻阻力检查亦正常)；临床并发症采用合并计算。

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表 3 2组鼻出血患者鼻腔伪膜脱落时间及鼻腔黏膜修复时间比较(x ±s，d)

组别	例数	鼻腔伪膜脱落时间	鼻腔黏膜修复时间
对照组	30	6.34±0.78	9.47±0.86
治疗组	30	4.64±0.66	6.66±0.53
t值		9.113	15.236
P值		＜0.001	＜0.001

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