Terakura Moriyuki, Fujisaki Ryuichi, Suda Takaoki, Sagawa Toshio, Sakamoto Tetsuya
Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan.
J Am Soc Hypertens. 2012 Jul-Aug;6(4):291-5. doi: 10.1016/j.jash.2012.05.001. Epub 2012 Jun 12.
Persistent nosebleed episodes have occurred in patients with idiopathic epistaxis from Kiesselbach's area despite confirmed location of the bleeding site, but the cause remains unclear. We tried to determine whether persistent epistaxis was associated with blood pressure.
Between May 2009 and May 2010, the records for 133 adult patients with idiopathic epistaxis from Kiesselbach's area were obtained from the emergency department of our hospital. The bleeding site was pressed with a cotton strip for about 30 minutes, followed by checking for nosebleed. Comparison of background factors by the presence or absence of persistent epistaxis revealed a significantly higher systolic blood pressure in patients with persistent nosebleed than in those without (181.3 ± 26.9 vs. 156.6 ± 26.1 mm Hg; P < .0001). Persistent epistaxis was significantly more frequent in patients with hypertension than in those without (26% vs. 8%; P = .002). Multivariate logistic analysis revealed systolic blood pressure to be an independent factor associated with epistaxis persistence (odds ratio, 1.03; 95% confidence interval, 1.01-1.06; P = .002).
Proper blood pressure management is necessary for the prevention of persistent epistaxis from Kiesselbach's area in the clinical setting of emergency care practice.
尽管已确定出血部位位于基氏区的特发性鼻出血患者仍会出现持续性鼻出血发作，但其病因尚不清楚。我们试图确定持续性鼻出血是否与血压有关。
2009年5月至2010年5月期间，从我院急诊科获取了133例基氏区特发性鼻出血成年患者的记录。用棉条按压出血部位约30分钟，然后检查是否仍有鼻出血。通过有无持续性鼻出血对背景因素进行比较，发现持续性鼻出血患者的收缩压显著高于无持续性鼻出血患者（181.3±26.9 vs. 156.6±26.1 mmHg；P <.0001）。高血压患者持续性鼻出血的发生率显著高于非高血压患者（26% vs. 8%；P =.002）。多因素逻辑分析显示收缩压是与鼻出血持续相关的独立因素（比值比，1.03；95%置信区间，1.01 - 1.0
