姚珊珊

【摘要】 目的：探究鼻內镜下射频及明胶海绵填塞治疗顽固性鼻出血的效果。方法：选取2013年1月-2016年4月笔者在中山火炬开发区院耳鼻喉科工作期间接诊的顽固性鼻出血患者64例为研究对象，将其分为单一组和联合组，各32例。单一组应用明胶海绵填塞治疗，联合组应用鼻内镜下射频及明胶海绵填塞治疗，均随访3个月，比较两组患者的临床疗效、生活质量评分及术后疼痛评分。结果：联合组患者的总有效率为93.75%，明显高于单一组的71.88%，比较差异有统计学意义（P<0.05）；联合组患者术后疼痛评分为（0.68±0.20）分，明显低于单一组的（2.24±0.61）分，比较差异有统计学意义（P<0.05）；联合组患者治疗后的躯体功能、心理功能、物质生活状态、社会功能及总生活质量评分分别为（82.65±4.35）、（81.24±4.61）、（82.74±3.55）、（80.69±4.95）、（81.69±4.35）分，均高于单一组评分，比较差异均有统计学意义（P<0.05）。结论：鼻内镜下射频及明胶海绵填塞治疗顽固性鼻出血具有显著的效果，有助于改善患者的生活质量，值得应用。

【关键词】 鼻内镜下射频； 明胶海绵； 顽固性鼻出血； 效果

Clinical Analysis of Radiofrequency Under Nasal Endoscopy and Gelatin Sponge Fillingin the Treatment of Intractable Epistaxis/YAO Shanshan.//Medical Innovation of China，2018，15（01）：129-132

【Abstract】 Objective：To explore the effect of radiofrequency under nasal endoscopy and gelatin sponge filling in the treatment of intractable epistaxis.Method：A total of 64 patients withintractable epistaxis were received during the work of the Department of ENT in the Zhongshan Torch Development Zone from January 2013 to April 2016 were selected，they were divided into single group and combined group，32 cases in each group.The single group was treated with gelatin sponge filling，and the combined group was treated with radiofrequency under nasal endoscopy and gelatin sponge filling，all patients were followed up for 3 months.The clinical efficacy，quality of life score and postoperative pain score of two groups were compared.Result：The total effective rate of combined group was 93.75%，which was significantly higher than single group of 71.88%，the difference was statistically significant（P<0.05）.The score of postoperative pain incombined group was（0.68±0.20）points，which was significantly lower than （2.24±0.61）points ofsingle group，the difference was statistically significant（P<0.05）.The scores of physical function，mental function，material life status，social function and total quality of life in combined group were respectively（82.65±4.35），（81.24±4.61），（82.74±3.55），（80.69±4.95），（81.69±4.35）points，which were all higher than those of single group，the differences were statistically significant（P<0.05）.Conclusion：Radiofrequency under nasal endoscopy and gelatin sponge filling has a significant effect on intractable epistaxis，which can helps to improve the quality of life of patients and is worthy of application.

【Key words】 Radiofrequency under nasal endoscopy； Gelatin sponges； Intractable epistaxis； Effect

First-authors address：Zhongshan Center for Disease Control and Prevention，Zhongshan 528403，Chinaendprint

doi：10.3969/j.issn.1674-4985.2018.01.036

鼻出血属于临床耳鼻喉科的常见症状，该症状可由全身疾病引起，亦可由鼻部疾病引起，而顽固性鼻出血在临床上亦称为“难治性鼻出血”，对患者实施常规治疗较难控制，该症状若不及时干预，严重者可出现失血性休克，因此，对其实施及时有效的治疗十分重要[1-3]。本研究对顽固性鼻出血患者分别实施明胶海绵填塞治疗和鼻内镜下射频及明胶海绵填塞治疗，以探究鼻内镜下射频及明胶海绵填塞的治疗效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2013年1月-2016年4月笔者在中山火炬开发区院耳鼻喉科工作期间接诊的顽固性鼻出血患者64例为研究对象。纳入标准：符合顽固性鼻出血的诊断标准；年龄>20岁；患者及家属均对本研究知情，且均已自愿签署同意协议。排除标准：合并严重肝肾功能不全、心脏疾病的患者；伴有精神障碍、药物过敏史的患者；妊……