Doroshenko L A, Barkagan L Z, Sokolova G S, Kosikhina T A
Vestn Otorinolaringol. 1991 Nov-Dec(6):38-41.
Early signs of haemorrhages develop in the childhood, nose bleeding being predominant. Recurrent nose bleeding was observed in 130 (89.0%) patients with thrombocytopathies, 37 patients with nasal pathologies, 13 out of 14 children having willebrand's disease, 3 patients suffering from Rendu-Osler disease, in a boy with a factor XIII deficiency, and in a girl with psoriasis. In the case of haemorrhagic diathesis, nose bleeding was, as a rule, combined with haemorrhages of other types (skin, gum, uterine, etc.) whereas in the case of ENT pathology, nose bleeding was the only haemorrhagic symptom. Medical examinations of patients suffering from recurrent nasal haemorrhages at the prehospital stage should include: study of the history case, ENT-doctor examination, and blood analysis using standard tests (micro-coagulation, prothrombin, hemolysate-aggregation). The battery of blood tests can be performed without costly equipment or reagents. It became routine in the work of a regular polyclinical laboratory and helped identify the causes of nose hemorrhages in 94.6% children.
出血的早期迹象在儿童期出现,鼻出血最为常见。130例(89.0%)血小板病患者、37例鼻腔疾病患者、14例患血管性血友病的儿童中的13例、3例患有遗传性出血性毛细血管扩张症的患者、1例患有因子XIII缺乏症的男孩以及1例患有银屑病的女孩均出现反复鼻出血。在出血素质的情况下,鼻出血通常与其他类型的出血(皮肤、牙龈、子宫等)合并出现,而在耳鼻喉科疾病的情况下,鼻出血是唯一的出血症状。对院前阶段反复鼻出血患者的医学检查应包括:病史研究、耳鼻喉科医生检查以及使用标准检测(微凝血、凝血酶原、溶血产物聚集)进行血液分析。一系列血液检测无需昂贵的设备或试剂即可进行。这在普通综合临床实验室的工作中已成为常规操作,有助于确定94.6%儿童鼻出血的原因。