Eshghi P, Jenabzade A, Habibpanah B
Hematology. 2014 Sep;19(6):361-4. doi: 10.1179/1607845413Y.0000000135. Epub 2013 Nov 25.
The aim of this study was to assess the effectiveness of localized treatments to persistently stop epistaxis in patients with inherited bleeding disorders.
In a self-controlled comparative clinical trial, to offer the best solution to stop epistaxis at home (within 10 minutes), patients with inherited bleeding disorders were treated using three different topical hemostatic agents, including Tranexamic acid impregnated tampon, EpiCell tampon prepared from oxidized regenerated cellulose pad, and ChitoHem tampon (reinforced with chitosan). The results of using these different products on three groups of randomly selected patients were ultimately compared using the χ(2) and Fisher's exact test statistics.
A total of 31 patients, 5 females and 26 males with a mean age of 5.6 years, were included in the study. Twenty-three patients had Glanzmann disease, four had von-Willebrand disease, two had Bernard soulier syndrome, two had activated factor VII deficiency, and one patient had impaired secretion of adenosine deaminase. The study exhibited that statistically there was no significant difference between EpiCell tampon and Tranexamic acid impregnated tampon treatments with respect to the hemostasis duration. However, ChitoHem tampon was more efficient than Tranexamic acid impregnated tampon (P value <0.001) and EpiCell tampon (P value < 0.05).
ChitoHem tampon, the chitosan-reinforced product, was the best therapy solution to stop epistaxis. We recommend further research on the use of other hemostatic agents for localized bleeding in patients with inherited bleeding disorders.
本研究旨在评估局部治疗对遗传性出血性疾病患者持续性鼻出血的止血效果。
在一项自身对照比较临床试验中，为了提供在家中（10分钟内）止血的最佳解决方案，使用三种不同的局部止血剂对遗传性出血性疾病患者进行治疗，包括氨甲环酸浸渍棉塞、由氧化再生纤维素垫制备的EpiCell棉塞和ChitoHem棉塞（用壳聚糖增强）。最终使用χ(2)检验和Fisher精确检验统计量比较在三组随机选择的患者中使用这些不同产品的结果。
共有31例患者纳入研究，其中5例女性，26例男性，平均年龄5.6岁。23例患者患有Glanzmann病，4例患有血管性血友病，2例患有Bernard soulier综合征，2例患有活化因子VII缺乏症，1例患者腺苷脱氨酶分泌受损。研究表明，在止血持续时间方面，EpiCell棉塞和氨甲环酸浸渍棉塞治疗之间在统计学上没有显著差异。然而，ChitoHem棉塞比氨甲环酸浸渍棉塞（P值<0.001）和EpiCell棉塞（P值<0.05）更有效。
壳聚糖增强产品ChitoHem棉塞是止血的最佳治疗方案。我们建议进一步研究其他止血剂在遗传性出血性疾病患者局部出血中的应用。
