Objective To investigate the efficacy and safety of endoscopic bipolar electrocoagulation in the treatment of refractory epistaxis, and to analyze the common bleeding sites and gender distribution characteristics in all ages of intractable epistaxis.
Methods A retrospective analysis was made on the diagnosis and treatment of 75 patients with intractable nasal hemorrhage in our department from November, 2014 to December, 2017 who were looked for blood spots for once or twice under nasal endoscope. The therapeutic effects of endoscopic bipolar electrocoagulation for refractory epistaxis were summarized and the occurrence of complications were analyzed. The common bleeding sites and gender distribution characteristics of various age groups in refractory nosebleeds were counted. The incidence of common bleeding sites and the gender distribution characteristics of various age groups were counted.
Results The curative rate of bipolar electrocoagulation for refractory nasal bleeding was 100%. The complication rate was 2.67%. In 68 patients, bleeding was found under nasal endoscope (64 hemorrhages were found for the first time) and no rebleeding occurred after bipolar electrocoagulation. All were single-arterial hemorrhage, mostly located in hidden place of nasal cavity. In turn, the inferior meatus were 50.67% (38/75), the septum surface of olfactory cleft 13.33% (10/75), the middle meatus 5.33% (4/75, screen bubble 2 case, the anterior wall of ethmoid sinus 1 case, the natural mouth in maxillary sinus 1 case), the rear of nasal septum 6.67% (5/75), the sag of nasal septum 4% (3/75), the rear of nasal septum deviation 6.67% (5/75), the methyl plate of middle turbinate and the rear of middle turbinate and the axillary region of middle turbinate each 1.33% (1/75), the bleeder what was not found 9.33% (7/75). The 7 cases with no identifiable bleeding point were treated with bipolar electrocoagulation and local packing treatment with suspicious bleeding and haematic mucosa, and no rebleeding was found. All patients did not choose the coagulation (ligation) of sphenopalatine artery. The incidence of epistaxis is more common in men than in women. The incidence is increasing after the age of 40. The incidence of women is increasing after the age of 50.
Conclusion The refractory nose bleed has good curative effect, less complications, high safety, and it is consistent with the concept of precision and minimal invasiveness and is worthy of clinical promotion and use. Common bleeding sites and gender distribution at different ages can guide clinical practice.
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