三种方法治疗鼻黎氏区出血疗效观察.docVIP

三种方法治疗鼻黎氏区出血疗效观察[摘要] 目的:比较三种治疗方法治疗不同类型鼻黎氏区出血的疗效,选择适当的治疗鼻出血的方法。方法:将194例患者随机分为三组,分别行微波热凝术(60例,A组)、出血区搔刮术(70例,B组)及贝复剂喷涂(64例,C组),术后随访1～6个月。结果:C组治疗血管增生型时疗效与其他组比较,有显著性差异(P0.05)。结论:鼻黎氏区出血应根据不同类型选用不同的疗效确切且安全的治疗方法。 [关键词] 鼻出血;微波;手术;贝复剂 [中图分类号] R765.23[文献标识码]A [文章编号]1673-7210(2010)02(b)-030-02 Effect of nose Lai’s area hemorrhage by three kinds of treatment methods JIANG Xia, HUANG Dingqiang, XU Yanhong, ZHU Rongfei, ZHU Yubo (Department of ENT, the People’s Hospital of Ya’an City, Sichuan Province, Ya’an625000, China) [Abstract] Objective: To compare the three kinds of treatment methods in treating different types of Lai’s nose bleeding area, and select the appropriate treatment method. Methods: 194 cases of patients were randomly divided into three groups, microwave coagulation (60 cases as A group), bleeding area saogua surgery (70 cases as B group) and bFGF spray (64 cases as C group), postoperative follow-up 1 to 6 months. Results: C group compared with the other groups on the efficacy of treatment of vascular proliferative, there was a significant difference (P0.05). Conclusion: Lai’s nose bleeding area should be selected different methods according to different types of treatment, which are the exact efficacy and safety. [Key words] Epistaxis; Microwave; Surgery; Basic fibroblast growth factor 鼻出血临床常表现为鼻常年多次反复出血,出血部位以黎氏区为多见,常给患者及患者家庭带来经济、心理及身体等各种各样的痛苦。临床治疗方法多样,为选择痛苦和成本小而且有效的治疗方法,本文对微波热凝术、出血区搔刮术、贝复剂喷涂三种方法治疗的效果进行比较, 现报道如下: 1 资料与方法 1.1 一般资料 选取2004年10月～2008年10月我院门诊鼻黎氏区出血患者194例, 表现为同一侧鼻腔常年多次反复出血,排除全身疾病和鼻腔鼻窦病变,就诊时无活动性出血。依黎氏区情况分为1组:血管粗大外露(62例);2组:黏膜肿胀粗糙呈颗粒状或糜烂、多处可疑出血点(86 例);3组:黏膜光滑无明显充血肿胀、出血点明确(46例)。其中,男101例,女93例;年龄2～53岁,平均24.6岁;病史均超过1年,无鼻部手术史。采用随机量表方法将病例随机分为A、B、C三组, A 组(60例)行微波热凝术,B 组(70例)行出血区搔刮术,C 组(64例)行贝复剂喷涂。 1.2 方法 A组患者取坐位,1%地卡因肾上腺素棉片表面麻醉患侧黎氏区,将微波治疗仪(珠海禾佳医疗设备有限公司FPH-IV耳鼻喉微波综合治疗仪)功率调到40 W,连接直治疗头(型号WEA),将治疗头前端紧贴出血点,用脚踏板控制治疗时间,直至出血区黏膜变白为止,治疗时间5～30 s,不需鼻腔填塞。B组患者取坐位,麻醉方法同A组,前鼻镜下用筛窦刮匙搔刮患侧黎氏区,区域需完全覆盖出血点及易出血区黏膜,直致黎氏区均匀渗血,用明胶海绵及凡士林油纱行鼻腔填塞至无活动