坦桑尼亚西北部一家三级护理医院鼻出血的病因及治疗结果：104例前瞻性研究
Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in Northwestern Tanzania: a prospective review of 104 cases.
作者信息
Gilyoma Japhet M, Chalya Phillipo L
机构信息
Department of Surgery, Weill- Bugando University College of Health Sciences, Mwanza, Tanzania.
出版信息
BMC Ear Nose Throat Disord. 2011 Sep 5;11:8. doi: 10.1186/1472-6815-11-8.
BACKGROUND
Epistaxis is the commonest otolaryngological emergency affecting up to 60% of the population in their lifetime, with 6% requiring medical attention. There is paucity of published data regarding the management of epistaxis in Tanzania, especially the study area. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Bugando Medical Centre, a tertiary care hospital in Northwestern Tanzania.
METHODS
This was a prospective descriptive study of the cases of epistaxis managed at Bugando Medical Centre from January 2008 to December 2010. Data collected were analyzed using SPSS computer software version 15.
RESULTS
A total of 104 patients with epistaxis were studied. Males were affected twice more than the females (2.7:1). Their mean age was 32.24 ± 12.54 years (range 4 to 82 years). The modal age group was 31-40 years. The commonest cause of epistaxis was trauma (30.8%) followed by idiopathic (26.9%) and hypertension (17.3%). Anterior nasal bleeding was noted in majority of the patients (88.7%). Non surgical measures such as observation alone (40.4%) and anterior nasal packing (38.5%) were the main intervention methods in 98.1% of cases. Surgical measures mainly intranasal tumor resection was carried out in 1.9% of cases. Arterial ligation and endovascular embolization were not performed. Complication rate was 3.8%. The overall mean of hospital stay was 7.2 ± 1.6 days (range 1 to 24 days). Five patients died giving a mortality rate of 4.8%.
CONCLUSION
Trauma resulting from road traffic crush (RTC) remains the most common etiological factor for epistaxis in our setting. Most cases were successfully managed with conservative (non-surgical) treatment alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort. Reducing the incidence of trauma from RTC will reduce the incidence of emergency epistaxis in our centre.
背景
鼻出血是最常见的耳鼻喉科急症，一生中高达60%的人会受到影响，其中6%需要医疗救治。关于坦桑尼亚鼻出血管理的已发表数据很少，特别是在研究区域。本研究旨在描述坦桑尼亚西北部一家三级护理医院布甘多医疗中心鼻出血的病因学特征和治疗结果。
方法
这是一项对2008年1月至2010年12月在布甘多医疗中心治疗的鼻出血病例的前瞻性描述性研究。收集的数据使用SPSS 15.0计算机软件进行分析。
结果
共研究了104例鼻出血患者。男性受影响的人数是女性的两倍多（2.7:1）。他们的平均年龄为32.24±12.54岁（范围4至82岁）。最常见的年龄组是31 - 40岁。鼻出血最常见的原因是外伤（30.8%），其次是特发性（26.9%）和高血压（17.3%）。大多数患者（88.7%）为鼻前部出血。在98.1%的病例中，主要的干预方法是非手术措施，如单纯观察（40.4%）和鼻前部填塞（38.5%）。1.9%的病例进行了手术措施，主要是鼻内肿瘤切除。未进行动脉结扎和血管内栓塞。并发症发生率为3.8%。住院总平均天数为7.2±1.6天（范围1至24天）。5例患者死亡，死亡率为%。
结论
在我们的研究环境中，道路交通挤压（RTC）导致的外伤仍然是鼻出血最常见的病因。大多数病例仅通过保守（非手术）治疗即可成功处理，大多数情况下可能无需手术干预及其潜在并发症，手术应作为最后手段。降低RTC外伤的发生率将降低我们中心紧急鼻出血的发生率。 （原文死亡率数据有误，应为4.8%，译文已修正）
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