本文選題：難治性鼻出血 + 定位��； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析在鼻內(nèi)鏡設(shè)備下電凝結(jié)合局部鼻腔填塞治療難治性鼻出血的利弊,評(píng)估其療效,總結(jié)難治性鼻出血在臨床上常見的出血部位。方法:選取60例自2015年12月至2017年2月期間收治于新疆醫(yī)科大學(xué)第四附屬醫(yī)院耳鼻咽喉科的難治性鼻出血病例,在鼻內(nèi)鏡下尋找明確出血點(diǎn),對(duì)其電凝治療,部分病例據(jù)情況予以紫草油紗條術(shù)后局部填塞治療,22例傳統(tǒng)鼻腔填塞治療的難治性鼻出血病例與上述60例比較得出患者臨床有效率、疼痛程度、術(shù)后并發(fā)癥、治療過程中出血量及術(shù)后鼻腔恢復(fù)情況的結(jié)果。結(jié)果:兩組82例患者中1次治愈74例,2次治愈79例,需經(jīng)過3次治療的僅4例,其中鼻內(nèi)鏡止血組60例病人總有效率100%。出血部位在下鼻道(多位于穹隆部)36例(43.90%)、鼻中隔中后部25例(30.49%)、中鼻道11例(13.41%)、鼻中隔前上部6例(7.32%)、嗅裂及蝶篩隱窩4例(4.88%),且以老年人為多數(shù)。結(jié)論:將鼻內(nèi)鏡技術(shù)熟練運(yùn)用在難治性鼻出血的治療上療效顯著,鼻內(nèi)鏡具有視野明亮開闊、微創(chuàng)、定位準(zhǔn)確、并發(fā)癥少等優(yōu)點(diǎn),符合微創(chuàng)外科的觀念。
[Abstract]:Objective: to analyze the advantages and disadvantages of electrocoagulation combined with local nasal packing in the treatment of intractable epistaxis, to evaluate the curative effect and to summarize the common bleeding sites in clinic. Methods: from December 2015 to February 2017, 60 cases of refractory epistaxis in the Department of Otorhinolaryngology, fourth affiliated Hospital of Xinjiang Medical University were selected. According to the situation, 22 cases of refractory epistaxis treated by traditional nasal packing were treated with local tamponade after the operation of purple oil gauze. Compared with the 60 cases mentioned above, the clinical effective rate, degree of pain, postoperative complications were obtained. Results of bleeding volume and recovery of nasal cavity after treatment. Results: of the 82 patients in the two groups, 74 cases were cured once and 79 cases were cured twice, only 4 cases needed 3 times treatment. The total effective rate was 100% in 60 cases of nasal endoscopy hemostasis group. The location of bleeding was in the inferior nasal canal (36 cases were located in the fornix, 25 cases were located in the middle and posterior part of the nasal septum), 11 cases were located in the middle nasal canal (13.41%), 6 cases in the upper part of the nasal septum, 4 cases in the olfactory fissure, 4 cases in the sphenoethmoid recess, and 4 cases in the elderly. Conclusion: the application of endoscopic technique in the treatment of intractable epistaxis is effective. Nasal endoscopy has the advantages of bright and open field of vision, minimally invasive, accurate positioning and less complications, which is in line with the concept of minimally invasive surgery.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765.9

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1 梅楨峰,孫敬武,王明善;難治性鼻出血的救治[J];中國急救醫(yī)學(xué);2000年02期

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本文編號(hào)：2039654