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目的分析鼻出血患者鼻内镜下射频和激光治疗的临床效果,对比两者的优缺点,探讨鼻出血的治疗方法。方法选择343例病情相似的鼻出血患者,在鼻腔表面麻醉下分别行射频和激光治疗,对比两组患者一次治愈率。选择出血部位在中隔前部,年龄20～60岁,病情相同者比较手术时间、手术中暂停手术次数,并通过视觉模拟量表(visualanaloguescales,VAS)比较两组患者的术中不适和医师心理压力评分。结果射频组与激光组一次治愈率分别为96.4%(186/193侧)和94.7%(179/189侧),两组相比无显著性差异(P>0.05)。手术时间(每5分钟计数1)射频组(2.54±0.93)小于激光组(4.65±1.47)(P<0.05);手术中因出血需暂停手术次数射频组[(1.21±0.31)次]少于激光组[(2.87±1.47)次](P<0.05);医师心理压力评分射频组[(2.84±0.72)分]小于激光组[(5.07±1.26)分](P<0.05),均有显著性差异。患者不适评分比较射频组[(6.73±2.06)分]和激光组[(6.91±1.78)分]无显著性差异(P>0.05)。结论鼻内镜检查直视下激光或射频治疗鼻出血均可取得较为理想的疗效,在治疗效果和手术中患者不适评分无明显差别的情况下,严格掌握规范操作,射频方法治疗鼻出血在手术时间、手术暂停次数和医师心理压力评分方面都体现出更多优势。
Objective To analyze the clinical effect of nasal endoscopic radiofrequency and laser treatment in patients with epistaxis and compare the advantages and disadvantages of the two methods to explore the treatment of epistaxis. Methods A total of 343 patients with similar epistaxis were enrolled in this study. Radiofrequency and laser treatments were performed under nasal surface anesthesia. The curative rates were compared between two groups. The bleeding sites were selected in the anterior septum, aged 20 to 60 years old. The patients in the same condition were compared with the operation time and the number of surgery was suspended. The intraoperative discomfort and physician psychology were compared between the two groups by visualanaloguescales (VAS) Pressure rating. Results The primary cure rate of radiofrequency group and laser group were 96.4% (186/193 side) and 94.7% (179/189 side), respectively. There was no significant difference between the two groups (P> 0.05). The radiofrequency group (2.54 ± 0.93) was smaller than that of the laser group (4.65 ± 1.47) (P <0.05). The frequency of the surgery in the radiofrequency group (1.21 ± 0.31) was less than (2.87 ± 1.47) in the laser group (P <0.05). The score of the physician stress group was significantly lower than that in the laser group [(2.84 ± 0.72) vs 5.07 ± 1.26 (P <0.05) Sex differences. There was no significant difference (P> 0.05) in the patients’ discomfort score compared with radiofrequency group [(6.73 ± 2.06)) and laser group (6.91 ± 1.78). Conclusions Nasal endoscopy under laser or radiofrequency treatment of nasal hemorrhage can achieve the desired effect, the treatment effect and surgical discomfort in patients with no significant difference in the circumstances, strictly regulate the operation of radio frequency method for the treatment of epistaxis in surgery Time, number of surgical pause and physician’s psychological stress score all showed more advantages.