鼻内镜下蝶腭动脉阻断术与上颌动脉栓塞术治疗难治性鼻出血的临床抉择

The ClinicalObservation of the Treatment of Refractory Nosebleeds Was Performed by the Nasal-Endoscopic Low-Temperature Plasma Sphenopalatine Artery Interruption or the Maxillary Artery Interventional Embolization

摘要: 目的：探讨应用鼻内镜下低温等离子蝶腭动脉阻断术与上颌动脉介入栓塞术治疗难治性鼻出血是否具有临床抉择标准。方法：选择我院住院病例中的采用鼻内镜下低温等离子蝶腭动脉阻断术与上颌动脉介入栓塞术治疗的难治性鼻出血病例共74例，采用回顾性分析的方法调研两组病例头鼻疼痛、生活质量(SF-36量表)评分、手术持续时间、住院费用、严重并发症发生率及一次性治愈率的差别。结果：两组患者手术持续时间、一次性治愈率均无显著性差异；头鼻疼痛、住院费用、严重并发症发生率介入组显著高于内镜组；生活质量评分内镜组显著高于介入组。结论：鼻内镜下低温等离子蝶腭动脉阻断术与上颌动脉介入栓塞术均为治疗难治性鼻出血的有效可选方案，优先梯度上应处于平等地位，应依据患者个体情况个体化选择。鼻内镜手术更精准，介入手术更微创。

Abstract: Objective: To explore whether there is a clinical choice standard for refractory nosebleeds by en-doscopic plasma sphenopalatine artery interruption or maxillary artery interventional emboliza-tion. Methods: To choose the total 74 cases of refractory nasal bleeding that were treated by the low temperature plasma endoscopic sphenopalatine palatal artery interruption or maxillary artery interventional embolization in our hospital, it was analyzed retrospectively that pain, the quality of life scale (SP-36) score, operation duration, hospitalization expenses, the incidence of serious complications and one-time cure rate in the two groups of cases. Results: There was no significant difference in the duration of operation and the one-time cure rate between the two groups. The incidence of head and nose pain, hospitalization cost and serious complications was significantly higher in the interventional group than in the endoscopic group. The quality of life score of the endoscopic group was significantly higher than that of the interventional group. Conclusion: Endoscopic plasma sphenopalatine artery occlusion and maxillary artery embolization are effective alternatives for the treatment of refractory epistaxis. The priority gradient should be equal, and the choice should be individualized according to the individual state of an illness. Nasal endoscopic surgery is more accurate and interventional surgery is more minimally invasive.