Evans Andrew S, Young David, Adamson Richard
Department of Otolaryngology and Head and Neck Surgery, Western General Hospital, Edinburgh.
J Laryngol Otol. 2004 Jan;118(1):12-4. doi: 10.1258/002221504322731556.
This retrospective observational study aimed to establish the outcome for patients packed with a nasal tampon as first-line therapy for epistaxis in Accident & Emergency compared to those packed by ENT. During our study period, 189 admissions were treated with a nasal tampon as first-line therapy; 89 were inserted by ENT and 100 by A&E. A significantly higher number of patients packed by A&E required further treatment to control bleeding (p = 0.004; 95 per cent CI 7-34) than those in the group packed by ENT. A significantly greater proportion from the A&E group required additional cautery alone to control bleeding (p = 0.005; 95 per cent CI 5-30). We suggest that this may be due to inadequate initial assessment and inappropriate first-line therapy in the A&E department. It is recommended that ENT review patients prior to packing, in order to reduce the morbidity associated with multiple treatments.
这项回顾性观察研究旨在确定，与耳鼻喉科（ENT）进行鼻腔填塞的患者相比，在急诊室（Accident & Emergency）将鼻腔填塞作为鼻出血一线治疗方法的患者的治疗结果。在我们的研究期间，189名患者接受了鼻腔填塞作为一线治疗；其中89名由耳鼻喉科进行填塞，100名由急诊室进行填塞。与耳鼻喉科填塞组相比，急诊室填塞的患者中需要进一步治疗以控制出血的人数显著更多（p = 0.004；95%置信区间7 - 34）。急诊室组中仅需额外烧灼止血的比例显著更高（p = 0.005；95%置信区间5 - 30）。我们认为这可能是由于急诊室初始评估不足和一线治疗不当所致。建议耳鼻喉科在填塞前对患者进行检查，以降低与多次治疗相关的发病率。
