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本文分析192例因鼻衄严重而住院的病例。病因分析计:高血压89,血液病15,手术后13,肿瘤4,外伤4,未明67例。处理方法分析计:前鼻孔充填61例,后鼻孔前鼻孔充填71例。手术处理计:颌内动脉结扎14,筛前动脉结扎6,颈外动脉结扎3,中隔矫正3,中隔植皮3,其他31(包括电灼)。颌内动脉结扎方法:用加肾上腺素之2％利多卡因局部麻醉,注入翼上颌裂、上唇下面、下鼻道及下鼻甲,经上颌窦径路,切除上颌窦骨性后壁,打开骨膜,露出脂肪垫,轻轻将脂肪移向窦内,去除脂肪后,即可见到颌内动脉,分别在动脉近侧端远侧端用银夹夹闭。全部病例即刻止血。作者并提出颈外动脉结扎虽然止鼻血的效果也很好,但其防碍了面部的重要循环。
This article analyzes 192 cases of serious hospitalization due to epistaxis. Etiology: Hypertension 89, hematological disease 15, postoperative 13, tumor 4, trauma 4, unknown 67 cases. Analysis of treatment methods: 61 cases of anterior nostril filling, nostril after nostril filling 71 cases. Surgical treatment plan: ligation of the maxillary artery 14, ligation of the anterior ethmoidal artery 6, ligation of the external carotid artery 3, correction of the septum 3, grafting in the septum 3, and other 31 (including electrocautery). Maxillary artery ligation method: 2% lidocaine plus epinephrine local anesthesia, into the wing maxillary fissure, the upper lip below the lower nasal passages and the inferior turbinate, the maxillary sinus approach to remove the maxillary sinus bony posterior wall, open the periosteum, Exposing the fat pad, gently move the fat to the sinus, remove the fat, you can see the internal carotid artery, respectively, in the proximal end of the proximal end of the artery clip with a silver clip. All cases immediately stop bleeding. The authors also propose that the ligation of the external carotid artery, although effective in stopping the nosebleed, hinders the vital circulation of the face.