Department of Oto Rhino Laryngology, OUH Svendborg Sygehus, Valdemarsgade 53, Svendborg, Denmark.
Eur Arch Otorhinolaryngol. 2011 Dec;268(12):1765-70. doi: 10.1007/s00405-011-1677-9. Epub 2011 Jun 26.
Earlier studies have shown the effect of laser treatment on epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). At the present time, only very few prospective trials have been performed, and many studies are based on patients' subjective assessment of the severity of epistaxis. This prospective study measures the objective effect of laser treatment in HHT patients with mild to moderate epistaxis. We introduce an objective measure to assess the severity of epistaxis: the bleeding time (BT). Before and after treatment, the quality of life, as measured by the patient, was assessed and compared to normative data. In 30 patients, we measured the BT before laser treatment 1.5 and 6.5 months after treatment. The Short form 36 (SF-36), a validated health questionnaire, was completed before and 6.5 months after treatment. Compared to preoperative value, BT was significantly reduced 1.5 and 6.5 months after laser treatment (p < 0.05) in both cases. No significant difference in quality of life, before and after treatment, was found. The quality of life of the HHT patients was reduced in five out of eight dimensions when compared with the Danish background population. Laser treatment reduces epistaxis in HHT patients with mild to moderate epistaxis for at least 6 months; this group of patients have reduced quality of life compared to the background population.
早期研究表明，激光治疗对遗传性出血性毛细血管扩张症（HHT）患者的鼻出血有效果。目前，仅进行了极少数前瞻性试验，许多研究都是基于患者对鼻出血严重程度的主观评估。本前瞻性研究旨在测量激光治疗对轻度至中度鼻出血的 HHT 患者的客观效果。我们引入了一种评估鼻出血严重程度的客观方法：出血时间（BT）。在治疗前后，我们通过患者评估并与标准数据进行比较来评估生活质量。在 30 例患者中，我们在激光治疗前、治疗后 1.5 个月和 6.5 个月测量了 BT。我们在治疗前和治疗后 6.5 个月完成了经过验证的健康问卷 36 项简短量表（SF-36）。与术前值相比，激光治疗后 1.5 个月和 6.5 个月 BT 明显降低（p<0.05）。治疗前后生活质量无显著差异。与丹麦背景人群相比，HHT 患者的生活质量在八个维度中的五个维度降低。激光治疗可减少至少 6 个月轻度至中度鼻出血的 HHT 患者的鼻出血；与背景人群相比，这组患者的生活质量降低。
