Oh Joon Taek, Bae Mi Rye
Department of Otorhinolaryngology-Head and Neck Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Republic of Korea.
J Rhinol. 2023 Mar;30(1):23-30. doi: 10.18787/jr.2023.00001. Epub 2023 Mar 30.
Epistaxis is one of the most common emergencies in otolaryngology, and the recently developed Rapid Rhino nasal pack, a balloon-type nasal packing device, is widely used in emergency departments. Rebleeding after initial treatment increases patients' discomfort and medical costs. The aim of this study was to investigate risk factors for rebleeding in patients treated with Rapid Rhino packing.
In this retrospective study, 93 patients with epistaxis treated with Rapid Rhino from January 2020 to November 2022 were divided into the well-controlled group (39 patients) and the rebleeding group (54 patients), and the baseline characteristics, management methods, and complications were compared between these groups. The rebleeding group was divided according to whether patients experienced a single episode of rebleeding (38 patients) or multiple rebleeding episodes (16 patients), and the differences between these two groups were compared.
Oral anticoagulation therapy was associated with a higher risk of rebleeding after Rapid Rhino packing (odds ratio [OR]=8.41, p=0.047). A history of nasal surgery was associated with multiple rebleeding (OR=22.55, p=0.009). Age, sex, the management method, complications, and the site of bleeding were not found to be related to rebleeding.
Patients with rebleeding after Rapid Rhino nasal packing had a higher rate of concurrent oral anticoagulation therapy. A history of nasal surgery was strongly associated with multiple episodes of rebleeding. A detailed medical history can be important for assessing the risk of rebleeding in epistaxis patients treated with Rapid Rhino packing.
鼻出血是耳鼻咽喉科最常见的急症之一，最近研发的快速犀牛鼻腔填塞物是一种球囊型鼻腔填塞装置，在急诊科广泛应用。初始治疗后再出血会增加患者的不适和医疗费用。本研究的目的是调查使用快速犀牛填塞物治疗的患者再出血的危险因素。
在这项回顾性研究中，将2020年1月至2022年11月使用快速犀牛填塞物治疗的93例鼻出血患者分为控制良好组（39例患者）和再出血组（54例患者），比较两组的基线特征、治疗方法和并发症。再出血组根据患者是经历单次再出血（38例患者）还是多次再出血（16例患者）进行分组，并比较这两组之间的差异。
快速犀牛填塞术后，口服抗凝治疗与再出血风险较高相关（比值比[OR]=8.41，p=0.047）。鼻部手术史与多次再出血相关（OR=22.55，p=0.009）。未发现年龄、性别、治疗方法、并发症和出血部位与再出血有关。
快速犀牛鼻腔填塞术后再出血的患者同时接受口服抗凝治疗的比例较高。鼻部手术史与多次再出血密切相关。详细的病史对于评估使用快速犀牛填塞物治疗的鼻出血患者的再出血风险可能很重要。
