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1、1About the treatment of intractable epistaxis under nasal endoscopyPapers network: Abstract Objective To investigate the treatment of the nasal endoscopy refractory epistaxis. Methods 28 cases of epistaxis front with nasal endoscopic row nasal gauze packing or nostrils, nasal tamponade failed to con
2、trol bleeding patients, in the nose The endoscope downstream oil the stuffer yarn and the use of microwave therapy treatment experience. Results 28 patients were one-time cure. conclusions nasal endoscope line nasal gauze packing and microwave therapy, to relieve the suffering of patients and reduce
3、 tamponade thorough risk . Keywords: epistaxis refractory nasal endoscopy Refers to the nasal cavity deep bleeding refractory nasal bleeding, recurrent bleeding point is difficult to determine, ENT refractory, one of the Intensive. Looking for an effective treatment, to avoid repeated the front nost
4、ril gauze packing, blind choanal tamponade and vascular thrombosis, vascular ligation caused the patient 2pain and risk, our department from 2010 to 2011, 28 cases of such patients in nasal endoscope down gauze packing and microwave treatment, satisfactory results are as follows: 1 Materials and Met
5、hods 1.1 Clinical data 28 patients, 10 males and 18 females, aged 22 to 81 years, with an average age of 42 years old, were unilateral. Including five cases of patients with hypertension. Above hospitalized patients to hospital outpatient and hospital more times before nostril after nostril gauze ta
6、mponade or tamponade bleeding is not complete in the nasal bleeding bleeding site: located under the five cases of nasal passages, located in a deviated nasal septum associated with recurrent nasal cavity, oropharyngeal bleeding or remove the stuffing bone ridge behind the three cases, is located at
7、 the rear end of the inferior turbinate three cases, in five cases of nasal passages, is located near the nose and nasal septum top of the three cases, and four cases in the nasopharynx, nasal mucosa widely oozing four cases, the small blood vessels in the nasal floor Tumor cases. 31.2 Treatment Pat
8、ient supine in the 0 degree nasal endoscope to remove the front and rear nostrils stuffing, to suction aspiration nasal hemorrhage, 1% tetracaine (10 ml 2 ml of 0.1% epinephrine cotton sheet to line the nasal mucosal surface anesthesia nasal endoscopy with the use of suction Find bleeding points, su
9、ch as bleeding point is not clear, head penetrometer with suspected bleeding area to attract induced bleeding. in endoscopic sinus guided along the direction of blood flow Find bleeding , such as bleeding has stopped should carefully check the nasal ministries can be observed in inferior turbinate i
10、mpact the inferior turbinate fracture displacement 1. clear bleeding point to 1% tetracaine adrenaline cotton piece oppression Hemorrhage until the bleeding to stop or reduce the microwave apparatus power adjusted to 40 45 w, therapeutic equipment foot control, direct contact with the microwave prob
11、e the bleeding site 1 to 3 seconds, mucosa turn white to the bleeding area as more severe bleeding is not easy see the bleeding point can be used to suppress bleeding area tetracaine adrenaline piece of cotton, and gradually open piece of cotton instantly see the bleeding area to 4microwave treatmen
12、t. microwave treatment after the wound is still oozing to gauze oppression wound. Nasal septum near the nose and the top of the nose bleeding due to the high position of small space, microwave treatment to maneuver to the bleeding area gauze packing, and the nasal mucosa to extensive bleeding the bl
13、eeding part gauze packing bleeding stopped. 1.3 after treatment Postoperative avoid blowing your nose and maintain smooth stool, and I intravenous antibiotics and hemostatic nostril gauze packing before 48 to 72 hours after taking the nasal packing gauze, conventional nasal drops intranasally to liq
14、uid paraffin oil week. reposted in the free papers Download Center http:/2 results 28 patients were followed up for a one-time cure .1 no further bleeding, no septal hematoma, perforation, complications turbinate adhesions occur and bleeding to hemorrhagic shock. 53 Discussion The key to the treatme
15、nt of epistaxis explicitly the bleeding etiology Find bleeding points. Nose microscope gauze packing and choanal tamponade limited vision not see the bleeding point for deep, bleeding, and the hidden parts of the bleeding, filling a certain blindness likely to cause tamponade inaccurate and invalid
16、tamponade of repeated tamponade caused by nasal mucosal damage, causing new bleeding and pain in patients with vascular ligation, efficacy generally fair, domestic Tao Zhengde reported 2 ligation of the 13 cases in 11 cases satisfactory result, its relatively complex, the patient is not easy to accept non-law of the regional distribution of nasal blood vessels, bilateral nasal blood vessels the anastomotic branch vessel ligation is easy to f
