中国耳鼻咽喉颅底外科杂志2026，Vol.32Issue(4)：56-60,5.DOI:10.11798/j.issn.1007-1520.202625477
鼻内镜术后鼻出血的临床特点及影响因素分析
Analysis of clinical characteristics and influencing factors of epistaxis after endoscopic sinus surgery
摘要
Abstract
Objective To investigate the clinical characteristics and influencing factors of epistaxis after endoscopic sinus surgery so as to provide a basis for clinical prevention and treatment of postoperative epistaxis.Methods From June 2020 to June 2025,44 patients with epistaxis after endoscopic sinus surgery admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of University of Science and Technology of China were selected as the experimental group,and 105 patients without postoperative epistaxis during the same period were collected as the control group.The clinical characteristics of postoperative epistaxis in the experimental group were analyzed.Comparative analysis between the experimental and control groups,along with multivariate logistic regression,was performed to identify the influencing factors of postoperative epistaxis.Results The highest incidence of postoperative epistaxis occurred within the first week after surgery(25.00%).The most common responsible vessel was the sphenopalatine artery(38.64%).The highest incidence of bleeding was observed in patients undergoing endoscopic sinus surgery for sinonasal tumors(36.36%).Electrocautery under general anesthesia was the most frequently used hemostatic method(38.64%).The experimental group had a significantly higher proportion of males and a history of anticoagulant use compared to the control group,while the preoperative use of hormones was lower in the experimental group(P<0.05).Multivariate logistic regression analysis indicated that male gender(95%CI:1.054～5.615,P=0.037)and a history of anticoagulant use(95%CI:1.167～109.846,P=0.036)were independent risk factors for postoperative epistaxis(P<0.05),while preoperative standardized use of glucocorticoids(95%CI:0.145～0.839,P=0.019)was a protective factor(P<0.05).Conclusions The incidence of postoperative epistaxis after endoscopic sinus surgery is the highest within the first week after surgery.The sphenopalatine artery is the most common responsible vessel.Surgery for sinonasal tumors carries the highest risk of bleeding.Electrocautery under general anesthesia is the primary treatment method.Male gender and a history of anticoagulant use increase the risk of bleeding,while preoperative standardized use of glucocorticoids can reduce the risk.Therefore,for high-risk patients such as males and those with a history of anticoagulant use,perioperative management should be enhanced,and preoperative standardized use of glucocorticoids should be considered to reduce the risk of bleeding.关键词
鼻出血/鼻内镜手术/影响因素Key words
Epistaxis/Endoscopic sinus surgery/Influencing factors分类
医药卫生引用本文复制引用
殷继风,尹飞,高炜,郭涛,汪银凤,孙家强,孙敬武,亓晓宇..鼻内镜术后鼻出血的临床特点及影响因素分析[J].中国耳鼻咽喉颅底外科杂志,2026,32(4):56-60,5.基金项目
国家自然科学基金项目(82271180 （）
82471179). （）
