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鼻出血

Epistaxis.

作者信息

Krulewitz Neil Alexander, Fix Megan Leigh

机构信息

Division of Emergency Medicine, University of Utah, 30 North 1900 East, Room 1C26, Salt Lake City, UT 84132, USA.

Division of Emergency Medicine, University of Utah, 30 North 1900 East, Room 1C26, Salt Lake City, UT 84132, USA.

出版信息

Emerg Med Clin North Am. 2019 Feb;37(1):29-39. doi: 10.1016/j.emc.2018.09.005.

Abstract

Most anterior epistaxis originates primarily from the Kiesselbach plexus, whereas posterior epistaxis is less common and originates from branches of the sphenopalatine artery. Risk factors include local trauma, foreign body insertion, substance abuse, neoplasms, inherited bleeding diatheses, or acquired coagulopathies. Assessment of airway, breathing, and circulation precedes identification of bleeding source, pain control, and achieving hemostasis. Management options include topical vasoconstrictors, direct pressure, cautery, tranexamic acid, nasal tampons, Foley catheters, or surgical intervention. Specialty consultation may be pursued if interventions fail. Disposition is typically to home unless posterior epistaxis or significant comorbidities exist that warrant admission.

摘要

大多数鼻出血主要起源于克氏静脉丛,而后鼻孔出血较少见,起源于蝶腭动脉分支。危险因素包括局部创伤、异物插入、药物滥用、肿瘤、遗传性出血性疾病或获得性凝血障碍。在确定出血源、控制疼痛和实现止血之前,先评估气道、呼吸和循环。治疗选择包括局部血管收缩剂、直接压迫、烧灼、氨甲环酸、鼻腔填塞、 Foley 导管或手术干预。如果干预失败,可寻求专科会诊。通常可出院回家,除非存在后鼻孔出血或有需要住院的严重合并症。

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