Effectiveness of Calcium Alginate Dressing in Combination with Nasal Endoscopic Bipolar Electrocoagulation and Low-Temperature Plasma Knife Treatment on Bleeding Volume, Nasal Ventilation, Stress Response, and Recurrence Rate in Patients with Refractory Epistaxis

Abstract

The aim of this study was to compare the effects of nasal endoscopic bipolar electrocoagulation (BE) and low-temperature plasma knife (LPK) treatment on intractable epistaxis (IE) in order to provide a reference and guidance for future treatment options for IE. A total of 109 patients with IE admitted to Dongying People’s Hospital from June 2021 to May 2022 were selected for the study. Of these, 58 were treated with BE (BE group) and 51 were treated with LPK (LPK group). The nasal cavities of patients in the BE and LPK groups were filled with a gelatin sponge and calcium alginate dressing, respectively, after surgery. The clinical efficacy, operation time, hemostasis time, and intraoperative bleeding volume of the two groups were compared. Patients’ unilateral inspiratory resistance (IR), expiratory resistance (ER), bilateral total inspiratory resistance (TIR), and total expiratory resistance (TER) were measured using a nasal resistance tester, and pain was assessed using a visual analog scale (VAS). Serum epinephrine (E), norepinephrine (NE), and cortisol (Cor) levels were also measured in patients before and after surgery, and complications were recorded. The recurrence of IE was measured at a 6-month follow-up after discharge from the hospital. There were no differences in clinical efficacy, hemostasis time, or intraoperative bleeding between groups (P >0.05), and the operative time was longer in both BE groups (P <0.05). In addition, postoperative IR, ER, TIR, and TER were higher in the BE group than in the LPK group, and the VAS score results were also higher at 1 d postoperatively (P <0.05). After surgery, E, NE, and Cor were elevated in both groups; more so in the BE group than in the LPK group (P <0.05). Differences in the incidence of complications and prognostic recurrence rates between groups were not statistically significant (P >0.05).