Comparison of different surgical procedures on patients with refractory nasal bleeding under nasal endoscopy

Abstract

Objective To investigate the clinical effects of different surgical procedures on patients with refractory nasal bleeding under nasal endoscope. Methods A total of 104 intractable epistaxis patients who accepted endoscopic surgery were selected as the research objects, 56 patients who were treated by endoscopic bipolar coagulation were chosen as group A, 24 patients underwent nasal endoscopic nasal septum surgery were chosen as the group B, 24 patients with the partial middle turbinectomy were chosen as group C. The location of nose bleeding in patients were counted before surgery, the clinical curative effect of three groups were compared with referring to standard of treatment of refractory nasal bleeding; ventilation recovery time, blood loss, postoperative recovery time of nasal mucosa in the three groups were compared; after the operation, the follow-up of three months was implemented, the intractable epistaxis recurrence rates, adhesion of nasal cavity, nasal septum perforation, epiphora, hyposmia, nasal dryness and headache and other complications were compared among the three groups. Results There were significant differences in the nasal bleeding sites among the three groups. The total effective rate of group A was 92.9%, and 95.7% in group B and 91.7% in group C, there was no significant difference among the three groups (P>0.05). In group A, the ventilation recovery time was (2.8±1.4)d, nasal mucosa recovery time was (5.2±1.6)d, intraoperative blood loss was (40.31±5.57) ml; and those were (3.0±1.7) d, (5.5±1.1) d, (68.23± 6.42) ml in group B and (2.8±1.1) d, (4.8±1.4) d, (74.24±6.62) ml in group C, respectively. The amount of intraoperative blood loss in group A was less than that in group B and group C(P 0.05). Postoperative follow-up of 3 months presented that the recurrence rate was 12.5% (7 cases) in group A, 16.7% (4 cases) in group B and 12.5% (3 cases) in group C. The postoperative recurrence rate and complications had no significant difference among the three groups (P>0.05). Conclusions Endoscopic bipolar coagulation therapy, septoplasty and partial turbinectomy are applied to different sites of bleeding patients, three surgical treatment can achieve good clinical efficacy, have similar clinical effects on preventing the recurrence of the disease, suitable surgical procedure can be chosen according to the bleeding points. Key words: Rrefractory nasal bleeding; Endoscopic sinus surgery; Different operation; Clinical effect