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目的探讨鼻内镜下难治性隐匿性鼻出血常见的出血部位及微创治疗。方法106例经常规鼻腔填塞未能控制的原发性鼻出血,通过鼻内镜下微创止血。结果出血部位依次为:嗅裂前上部58例(54.7%),下鼻道穹隆部36例(34.0%),中鼻道7例(6.6%),部位不明者5例(4.7%)。1次治愈92例(86.8%),2次治愈9例(8.5%),3次治愈5例(4.7%)。随访1～3个月无复发。结论难治性隐匿性鼻出血出血部位多为嗅裂前上部和下鼻道穹隆部,鼻内镜下灵活选择不同的微创止血方法可提高鼻出血治愈率。
Objective To investigate the common bleeding sites and minimally invasive treatment of refractory occult nasal bleeding under endoscopic sinus surgery. Methods A total of 106 cases of primary nasal bleeding uncontrolled by conventional nasal packing were treated with endoscopic minimally invasive surgery. Results The bleeding sites were as followed: 58 cases (54.7%) of the anterior superior olfactory bulb, 36 cases (34.0%) of the inferior nasal vault, 7 cases of middle meridian (6.6%) and 5 cases (4.7%) of unidentified parts. One treatment was cured in 92 cases (86.8%), the other two treatments were cured in 9 cases (8.5%) and three treatments were cured in 5 cases (4.7%). Follow-up 1 to 3 months without recurrence. Conclusions Most of the intractable occlusive hemorrhage of nosebleed are mostly the anterior superior olfactory branch and the inferior nasal vault. Nasal endoscopic selective flexible minimally invasive hemostasis can improve the cure rate of nasal hemorrhage.