การส่องตรวจและรักษาผู้ป่วยที่มีเลือดออกในโพรงจมูกด้วยกล้อง ประสบการณ์ในโรงพยาบาลนครปฐม

บทคัดย่อ

          From retrospective study in patients who came to Nakhonpathom Hospital with acute  or chronic nose bleeding, since October 1993 to September 1997. Of 87 cases who received endoscopic! microscopic nasal examination to search for bleeding sites. Fourty eight cases classified to be anterior epistaxis, included anterior non-specific 15 cases, anterior septal 22 cases, middle meatus 7 cases, inferior meatus 4 cases. Twelve cases classified to be posterior epistaxis,  included posterior non-specific 10 cases, posterior lateral wall 1 case, posterior septal 1 case.  And no bleeding can be detected in 27 cases. Selection of the methods to stop nose bleeding which appropriated for each patients, determines from bleeding sites and nasal structure. Localized treatments by endoscopic assisted showed good results.

          In cases with anterior septal bleeding. 21 cases treated by electrocoagulation, only 2  cases have rebleeding.

          In cases with middle meatal bleeding. 1 case treated by electrocoagulatuion and 2 cases  treated with miniature packing, no cases have rebleeding.

          In cases with inferior meatal bleeding. 4 cases treated with electrocoagulation, no cases have rebleeding.

          In 1 case with posterior septal bleeding and other 1 case with posterior lateral wall bleeding treated by endoscopic electrocautery, no cases have rebleeding.