Thangavelu Kruthika, Köhnlein Sabine, Eivazi Behfar, Gurschi Mariana, Stuck Boris A, Geisthoff Urban
Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg, Baldingerstraße, 35043, Marburg, Deutschland.
MED-HNO, Schwerpunktpraxis für HNO-Heilkunde, Kopf-Hals-Chirurgie und Plastische Operationen am Alice Hospital Darmstadt, Darmstadt, Deutschland.
HNO. 2021 Nov;69(11):931-942. doi: 10.1007/s00106-021-01110-4. Epub 2021 Oct 13.
Nosebleeds (epistaxis) are usually minor. Medical intervention is only necessary in about 6% of cases. The source of bleeding is frequently located in the anterior region of the nose (Kiesselbach's plexus). The estimated lifetime prevalence of epistaxis is 60%. Diffuse epistaxis is often a manifestation of systemic disease. Epistaxis is the leading symptom of Rendu-Osler-Weber disease (hereditary hemorrhagic telangiectasia, HHT). If intervention is required, the first-choice of treatment is bidigital compression for several minutes. Common therapeutic measures include local hemostasis using electrocoagulation or chemical agents, e.g., silver nitrate. Resorbable anterior nasal tampons or tampons with a smooth surface are also frequently employed. In case of failed surgical closure of the sphenopalatine artery, angiographic embolization is the method of choice.
鼻出血通常并不严重。仅约6%的病例需要医学干预。出血部位常位于鼻腔前部（克氏静脉丛）。鼻出血的终生患病率估计为60%。弥漫性鼻出血常是全身性疾病的一种表现。鼻出血是遗传性出血性毛细血管扩张症（Rendu-Osler-Weber病，HHT）的主要症状。如果需要干预，首选治疗方法是双指压迫数分钟。常见的治疗措施包括使用电凝或化学制剂（如硝酸银）进行局部止血。也经常使用可吸收的前鼻孔填塞物或表面光滑的填塞物。如果蝶腭动脉手术结扎失败，血管造影栓塞是首选方法。
