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目的:探讨鼻出血的原因、部位及有效治疗方法。方法:对234例鼻出血住院患者的临床资料进行回顾性分析。结果:鼻出血原因中以高血压居多(32.5%),出血部位以鼻腔后部、后鼻孔及鼻咽部居多,共40例(17.1%),其次为鼻中隔Little区,33例(14.1%)。治疗采用鼻腔填塞210例(89.7%),电灼及微波治疗14例(6.0%),硝酸银烧灼治疗6例(2.6%),鼻中隔黏膜下剥离术4例(1.7%)。经反复鼻腔填塞无效的14例改用非鼻腔填塞法止血,其中筛前动脉结扎术1例、颈外动脉结扎术1例,余12例采用数字减影血管造影术和动脉栓塞术治疗。结论:高血压是引起鼻出血的主要原因。出血部位主要位于鼻腔后部及鼻中隔后部,其次为鼻中隔Little区。治疗的主要手段仍为鼻腔填塞,数字减影血管造影和动脉栓塞术是治疗严重鼻出血的有效方法。
Objective: To investigate the causes, location and effective treatment of epistaxis. Methods: The clinical data of 234 cases of hospitalized patients with epistaxis were analyzed retrospectively. Results: Most of the causes of epistaxis were hypertension (32.5%). Bleeding sites were mostly posterior nasal cavity, posterior nasal cavity and nasopharynx, with 40 cases (17.1%) followed by Little area of nasal septum, 33 cases (14.1% . Nasal packing was used in 210 cases (89.7%), electrocautery and microwave treatment in 14 cases (6.0%), silver nitrate cautery in 6 cases (2.6%) and nasal septum submucosal dissection in 4 cases (1.7%). After repeated nasal packing invalid conversion to non-nasal packing method to stop bleeding, including 1 case of anterior ethmoidal ligation, ligation of the external carotid artery in 1 case, the remaining 12 cases were treated by digital subtraction angiography and arterial embolization. Conclusion: Hypertension is the main cause of epistaxis. Bleeding site mainly located in the posterior nasal cavity and posterior nasal septum, followed by the nasal septum Little area. Treatment is still the main means of nasal packing, digital subtraction angiography and arterial embolization is an effective method of treatment of severe epistaxis.