Van Wyk F C, Massey S, Worley G, Brady S
ENT Department, Worthing Hospital, Worthing, UK.
J Laryngol Otol. 2007 Mar;121(3):222-7. doi: 10.1017/S0022215106003148. Epub 2006 Oct 11.
Epistaxis is the most common nasal emergency and if nasal packing is required this commonly results in admission.
A literature search could find no published (UK) protocols for the management of this common condition in accident and emergency (A&E) departments. This paper presents a retrospective review of 116 patients with epistaxis, following implementation of the new peer reviewed protocol in June 2004.
Apart from cautery, 62 had nasal packing inserted. Only 17 required admission. Forty-six patients were discharged with nasal packing in situ and only seven (16 per cent) returned due to bleeding. The overall return rate was 11 per cent.
We feel this is a safe and logical protocol. Compared to mandatory admission after nasal pack insertion, we saved 39 admissions in five months. There were also the added benefits to patients of being able to recuperate at home rather than in hospital and avoidance of the risk of hospital acquired infection.
鼻出血是最常见的鼻部急症，若需要进行鼻腔填塞，通常会导致患者住院。
文献检索未发现英国关于急症科处理这一常见病症的已发表方案。本文对2004年6月实施新的经同行评审的方案后116例鼻出血患者进行了回顾性研究。
除烧灼治疗外，62例患者进行了鼻腔填塞。仅17例需要住院。46例患者鼻腔填塞后出院，仅7例（16%）因出血返回。总体返回率为11%。
我们认为这是一个安全且合理的方案。与鼻腔填塞后强制住院相比，我们在五个月内减少了39例住院。此外，患者还能在家中而非医院康复，避免了医院获得性感染的风险。
