下鼻道后穹窿部鼻出血特点及内镜治疗分析

Clinical characteristics and endoscopic treatment of epistaxis at posterior fornix of inferior meatus

摘要:

目的探讨下鼻道后穹窿部鼻出血的临床特点及治疗方法。方法回顾性分析2017年1月~2017年6月收治的5例下鼻道后穹窿部鼻出血患者的临床资料，5例患者均为反复、频发、动脉性出血，出血位置隐蔽，常规行前后鼻孔填塞后仍反复间断出血，所有患者均在全麻鼻内镜下行鼻腔探查及电凝止血术。结果5例患者均在术中探及出血点位于下鼻道后穹隆部，通过电凝止血术一次止血成功，随访1~3个月均未复发。结论临床中反复顽固性鼻出血、前后鼻孔填塞无效时，需考虑下鼻道后穹隆部出血，鼻内镜下单极电凝止血疗效肯定。

Abstract:

ObjectiveTo explore clinical features of and treatment method for epistaxis at posterior fornix of inferior meatus.MethodsClinical data of 5 patients suffering from epistaxis at posterior fornix of inferior meatus treated in our department from Jan 2017 to June 2017 were analyzed retrospectively. Frequent arterial epistaxis with hidden bleeding location occurred repeatedly after anterior and posterior nasal packing. All the patients received nasal exploration and electrocoagulation under nasal endoscope.ResultsEndoscopic exploration revealed that the bleeding site was located at the posterior fornix of the inferior meatus in all the 5 patients. Primary hemostasis was successfully achieved by endoscopic electrocoagulation and no recurrence occurred during followup ranged from one month to three months.ConclusionEpistaxis of posterior fornix of inferior meatus should be taken into account when intractable epistaxis occurs frequently and anteriorposterior nasal cavity packing is ineffective. The curative effect of endoscopic unipolar electrocoagulation is definite for hemostasis.