Premachandra D J
James Paget Hospital, Great Yarmouth.
J Laryngol Otol. 1991 Jan;105(1):17-9. doi: 10.1017/s0022215100114719.
Posterior epistaxis is usually treated by repeated nasal packing and in failed situations by ligation of feeding arteries with considerable morbidity and mortality. The most logical approach should be location of the bleeding site and arrest of haemorrhage by local treatment. The exact location of the bleeding area can be identified in actively bleeding noses with the fibreoptic naso-laryngoscope and the bleeding arrested by chemical, or thermal cautery and in failed situations by using small nasal packs confined to the bleeding site. This approach to the management of posterior epistaxis is effective and reduces the duration of hospital stay. It significantly reduces the discomfort to the patient. The current practice of indiscriminate blind nasal packing in the hope of arresting nasal haemorrhage by incidental pressure on the bleeding site should be re-evaluated.
鼻后段出血通常采用反复鼻腔填塞治疗，若填塞失败，则通过结扎供血动脉治疗，但这种方法会带来较高的发病率和死亡率。最合理的方法应该是确定出血部位，并通过局部治疗来止血。在活动性鼻出血时，可使用纤维鼻咽喉镜确定出血区域的确切位置，通过化学烧灼或热烧灼止血，若失败，则使用局限于出血部位的小鼻填塞物止血。这种治疗鼻后段出血的方法有效，可缩短住院时间，还能显著减轻患者的不适。当前盲目进行鼻腔填塞，寄希望于通过对出血部位偶然施加压力来止血的做法应重新评估。
