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目的明确鼻出血常见的出血部位以及探讨其对经前鼻镜鼻腔填塞治疗的指导意义。方法2005年5月至2006年12月共190例患者经前鼻镜检查未能发现出血点,对其中的156例患者行鼻内窥镜检查及填塞,并总结鼻出血好发部位与年龄的关系;对34例因各种原因无法行鼻内镜检查治疗者根据总结的结果经前鼻镜分别行嗅裂区、下鼻道填塞。结果156例患者出血部位依次为:下鼻道顶部57.1%(89/156)、嗅裂区29.5%(46/156)、后鼻孔缘及鼻底部后端8.3%(13/156),其余部位出血及未发现出血部位5.1%(8/156)。出血部位与年龄有一定的相关性,59岁以下年龄组以下鼻道顶部出血最常见69.7%(83/119),而60岁以上组则以嗅裂区易出血63.9%(23/36)。34例未行鼻内镜检查患者,根据我们总结的结果填塞后,91.2%(31/34)得到治愈。结论鼻内镜技术对于明确鼻腔出血部位具有重要意义。对前鼻镜检查未能发现出血点,而患者又经济困难,鼻腔较狭窄无法进行鼻内窥镜检查以及尚未开展鼻内镜止血的医院,嗅裂区、下鼻道予以明胶海绵填塞也有良好的治疗效果。
Objective To clarify the common bleeding site of nasal hemorrhage and to explore its guiding significance for the treatment of nasal packing by anterior nasal endoscopy. Methods From May 2005 to December 2006 a total of 190 patients were found to have no bleeding spot by prethronal rhinoscopy. One hundred and fifty-six patients underwent endoscopic sinus surgery and tamponade. The incidence of nasal bleeding and age Relationship; 34 cases due to various reasons can not be endoscopic treatment of patients according to the results of the summary of pre-operative nasal debridement, nasal packing. Results The bleeding sites of 156 patients were 57.1% (89/156) at the top of the inferior nasal passages, 29.5% (46/156) at the olfactory fissure area, 8.3% (13/156) at the posterior nasal border and the posterior end of the nasal floor, Bleeding and bleeding were not found in 5.1% (8/156). Bleeding site and age have a certain relevance, the most common nasal hemorrhage below the age of 59 under the age group of the most common 69.7% (83/119), while the group over the age of 60 was easy to bleed in the olfactory fissure 63.9% (23/36). Of 34 patients who did not undergo endoscopic examination, 91.2% (31/34) of the patients were cured on the basis of the results we summarized. Conclusions Endoscopic technique is of great importance to clarify the site of nasal bleeding. Bleeding points were not found in the anterior rhinoscopy, and the patients were in financial difficulty. The narrow nasal cavity was not suitable for endoscopic sinus surgery and the hospital for nasal endoscopic hemostasis was not used. Olfactory fissures and gelatin sponge in the inferior nasal passages were also well packed Therapeutic effect.