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鼻内药物治疗小儿特发性复发性鼻出血的疗效与安全性

Efficacy and Safety of Intranasal Medical Management in Pediatric Patients with Idiopathic Recurrent Epistaxis.

作者信息

Ozdamar Osman Ilkay, Ozbilen Acar Gul

机构信息

Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Otorhinolaryngology Head and Neck Surgery, Istanbul, Turkey.

出版信息

Medeni Med J. 2020;35(1):1-7. doi: 10.5222/MMJ.2020.78614. Epub 2020 Feb 28.

DOI:10.5222/MMJ.2020.78614
PMID:32733743
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7384491/
Abstract

OBJECTIVE

The goal of the study was to verify the efficacy and safety of topical medical treatment in idiopathic recurrent pediatric epistaxis patients by intranasal usage of both an antimicrobial and a moisturizing agent as a first-step management modality.

METHOD

Sixty-seven out of 326 pediatric patients with idiopathic recurrent epistaxis selected on a chart review of follow-up were enrolled in the study. The study was designed as an analysis of two groups: one group included 35 individuals (52.2% of the total cohort) having a hyperemic nasal mucosa and the second group included 32 individuals (47.8% of the total cohort) having a hypervascular nasal mucosa on physical examination before treatment.

RESULTS

The study was performed with a total of 67 children (age range 3-17 years) including 36 males (53.7% of total cohort) and 31 females (46.3% of total cohort). The mean age was 9.78±4.09 years. There was not any statistically significant difference between the groups in terms of age, duration of follow-up and recurrence time of epistaxis (p>0.05). Recurrence of epistaxis was seen in 22.9% (8/35) of hyperemic nasal mucosa group and in 34.4% (11/32) of hypervascular nasal mucosa group (p>0.05).

CONCLUSION

We advise the use of both an intranasal antimicrobial ointment and a mucosal moisturizing gel as an effective, noninvasive and easily applicable medical treatment option for pediatric patients with idiopathic recurrent epistaxis before more invasive methods of epistaxis control.

摘要

目的

本研究的目的是通过鼻内使用抗菌剂和保湿剂作为第一步管理方式,验证局部药物治疗在小儿特发性复发性鼻出血患者中的疗效和安全性。

方法

在对随访病历进行回顾性分析后,从326例小儿特发性复发性鼻出血患者中选取67例纳入研究。本研究设计为两组分析:一组包括35例(占总队列的52.2%)鼻黏膜充血的个体,另一组包括32例(占总队列的47.8%)治疗前体格检查发现鼻黏膜血管增生的个体。

结果

本研究共纳入67例儿童(年龄范围3 - 17岁),其中男性36例(占总队列的53.7%),女性31例(占总队列的46.3%)。平均年龄为9.78±4.09岁。两组在年龄、随访时间和鼻出血复发时间方面均无统计学显著差异(p>0.05)。鼻黏膜充血组鼻出血复发率为22.9%(8/35),鼻黏膜血管增生组为34.4%(11/32)(p>0.05)。

结论

我们建议在采用更具侵入性的鼻出血控制方法之前,将鼻内抗菌软膏和黏膜保湿凝胶作为小儿特发性复发性鼻出血患者一种有效、无创且易于应用的药物治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/7384491/301954da537c/MEDJ-35-001-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/7384491/5a19c9050ab3/MEDJ-35-001-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/7384491/d2659248e168/MEDJ-35-001-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/7384491/301954da537c/MEDJ-35-001-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/7384491/5a19c9050ab3/MEDJ-35-001-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/7384491/d2659248e168/MEDJ-35-001-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/7384491/301954da537c/MEDJ-35-001-f3.jpg

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本文引用的文献

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Emergency Department care of childhood epistaxis.儿童鼻出血的急诊科护理
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Nasal Bacterial Colonization in Pediatric Epistaxis: The Role of Topical Antibacterial Treatment.小儿鼻出血中的鼻腔细菌定植:局部抗菌治疗的作用
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Predictors of bleeding disorders in children with epistaxis: value of preoperative tests and clinical screening.鼻出血患儿出血性疾病的预测因素:术前检查和临床筛查的价值
Int J Pediatr Otorhinolaryngol. 2012 Jun;76(6):767-71. doi: 10.1016/j.ijporl.2012.02.033. Epub 2012 Mar 27.
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Is local ointment or cauterization more effective in childhood recurrent epistaxis.局部涂抹药膏或烧灼术对儿童复发性鼻出血哪种更有效?
Int J Pediatr Otorhinolaryngol. 2012 Jun;76(6):783-6. doi: 10.1016/j.ijporl.2012.02.040. Epub 2012 Mar 10.
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Prospective double blind randomized clinical trial comparing 75% versus 95% silver nitrate cauterization in the management of idiopathic childhood epistaxis.一项前瞻性双盲随机临床试验,比较75%与95%硝酸银烧灼法治疗儿童特发性鼻出血的效果。
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Childhood epistaxis and nasal colonization with Staphylococcus aureus.儿童鼻出血与金黄色葡萄球菌鼻腔定植
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Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: five-year follow up of a randomised, controlled trial.儿童复发性鼻出血用抗菌乳膏的长期疗效:一项随机对照试验的五年随访
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