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目的:总结鼻内镜下高频电刀治疗顽固性鼻出血的临床经验。方法:回顾性分析经鼻内镜引导下高频电刀治疗62例非外伤性、顽固性鼻出血患者的临床资料。结果:出血部位在嗅裂鼻中隔部22例(35.5%),下鼻道顶部19例(30.7%),中鼻甲后端蝶腭动脉区9例(14.5%),下鼻道外侧壁8例(12.9%),Woodruff静脉丛2例(3.2%),出血部位不明者2例(3.2%)。1次治愈60例(96.8%),2次治愈2例(3.2%),治愈率100%,随访3个月无复发。结论:各种手段暴露出血点是止血的关键;对非活动出血通过擦拭刺激或电凝相关血管供应分支达到目的;高频电刀的输出功率不宜过大。
Objective: To summarize the clinical experience of intranasal endoscopic electrosurgical treatment of intractable epistaxis. Methods: The clinical data of 62 cases of non-traumatic and refractory epistaxis treated by endoscopic ultrasonography were retrospectively analyzed. Results: The bleeding site was in 22 cases (35.5%) in nasal septum, 19 cases (30.7%) in the inferior nasal passages, 9 cases (14.5%) in the posterior end sphenopalatine artery of middle turbinate, 8 cases 12.9%), Woodruff venous plexus in 2 cases (3.2%) and bleeding site in 2 cases (3.2%). One cure was in 60 cases (96.8%), the other was cured in 2 cases (3.2%). The cure rate was 100%. No recurrence was observed in 3 months. Conclusion: Bleeding points exposed by various means are the key to hemostasis. The purpose of non-active hemorrhage can be achieved by wiping stimulation or blood vessel supply branches related to electrocoagulation. The output power of high frequency electric knife should not be too large.