Huang Ching-Ling, Shu Chih-Hung
Department of Otorhinolaryngology, Taipei Veterans General Hospital, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 2002 Feb;65(2):74-8.
Epistaxis is a common disease. That is usually self-limited and controlled by extemal compression. However, posterior epistaxis is occasionally complicated and needs hospitalization. The aim of this study is to analyze the etiology of epistaxis that requires hospitalization, and present the results of the treatments.
From June 1997 to May 1999, 44 patients admitted under diagnosis of epistaxis were retrospectively investigated. Among these patients, 7 were admitted twice for epistaxis. The demographics, administrative history, post-history and associated diseases, treatment and complications were analyzed. Noninterventional treatment comprised of nasal packing and local electrocauterization; interventional treatment included surgery and embolization.
The mean age of the patients enrolled was 53.4 years. Men outnumbered women in a rate of 3:1. The mean length for hospital stays was 8.1 days for noninterventionally-treated patients, 11.8 days for interventionally-treated patients. Emergency room visit prior to admission was noted in 68.6% of the patients. Hypertension, nasopharyngeal carcinoma (NPC) after radiotherapy, a history of nasal operations and smoking were four major associated diseases. The failure rate to control the epistaxis was 26.7% for noninterventional treatments and 16.7% for interventional treatments. The complication rate was 2% for the entire study, and the mortality rate was 7.8%. All the mortal patients were post-irradiation NPC patients with internal carotid artery bleeding.
Most epistaxis patients can be managed in a noninterventional manner. Interventional treatment is only warranted in those whose epistaxis persists after adequate noninterventional treatment. For internal carotid artery epistaxis in NPC patients, embolization should be performed as soon as possible.
鼻出血是一种常见疾病，通常具有自限性，可通过外部压迫得到控制。然而，后鼻孔出血偶尔会较为复杂，需要住院治疗。本研究旨在分析需要住院治疗的鼻出血的病因，并呈现治疗结果。
对1997年6月至1999年5月期间因鼻出血诊断入院的44例患者进行回顾性研究。其中7例患者因鼻出血再次入院。分析了患者的人口统计学资料、既往史、病史及相关疾病、治疗方法和并发症。非介入治疗包括鼻腔填塞和局部电灼；介入治疗包括手术和栓塞。
纳入患者的平均年龄为53.4岁。男性患者数量多于女性，比例为3:1。非介入治疗患者的平均住院时间为8.1天，介入治疗患者为11.8天。68.6%的患者在入院前曾到急诊室就诊。高血压、放疗后鼻咽癌（NPC）、鼻部手术史和吸烟是四种主要相关疾病。非介入治疗控制鼻出血的失败率为26.7%，介入治疗为16.7%。整个研究的并发症发生率为2%，死亡率为7.8%。所有死亡患者均为放疗后NPC患者，伴有颈内动脉出血。
大多数鼻出血患者可以采用非介入方式进行治疗。只有在经过充分的非介入治疗后鼻出血仍持续的患者中才需要进行介入治疗。对于NPC患者的颈内动脉鼻出血，应尽快进行栓塞治疗。
