Stangerup S E, Thomsen H K
Department of Otolaryngology, Gentofte University Hospital, Copenhagen, Denmark.
Rhinology. 1996 Mar;34(1):14-7.
Many years ago the treatment of posterior epistaxis was irrigation with hot water through the bleeding nose cavity, and the treatment was successful in many cases. The aim of this study is to explain how "hot-water irrigation" can cause haemostasis. Twenty-four rabbits were divided into 12 groups and their noses were irrigated for 5 min with hot water at temperatures ranging from 40-60 degrees C. After irrigation, the nose was fixed, sliced, stained, and evaluated blindly by a pathologist. The morphological changes-narrowing of intranasal lumen, vasodilation and stasis, extravasation of erythrocytes, and epithelial necrosis-were recorded. No changes were recorded after irrigation with water of 40-44 degrees C. Only light changes were present in the 46 degrees C group. Vasodilation occurred at a temperature of 48 degrees C or higher. From 48 degrees C, oedema of the mucosa and subsequent narrowing of the intranasal lumen was seen. Severe changes including epithelial necrosis, were found only in the groups treated with 52 degrees C or higher. The results of the study indicate that the haemostatic effect of hot water treatment for epistaxis may be caused by: (1) oedema and narrowing of the intranasal lumen, (2) vasodilation of the mucosal vessels, and (3) cleaning of the nose from blood coagulates.
许多年前，后鼻孔出血的治疗方法是通过出血的鼻腔用热水冲洗，这种治疗方法在很多病例中都取得了成功。本研究的目的是解释“热水冲洗”如何导致止血。将24只兔子分为12组，用40 - 60摄氏度的热水对它们的鼻腔进行5分钟的冲洗。冲洗后，将鼻子固定、切片、染色，然后由病理学家进行盲法评估。记录形态学变化——鼻内管腔变窄、血管扩张和淤血、红细胞外渗以及上皮坏死。用40 - 44摄氏度的水冲洗后未记录到变化。46摄氏度组仅出现轻微变化。48摄氏度及以上温度时出现血管扩张。从48摄氏度开始，可见黏膜水肿及随后的鼻内管腔变窄。仅在52摄氏度及以上温度处理的组中发现包括上皮坏死在内的严重变化。该研究结果表明，热水治疗鼻出血的止血作用可能由以下原因引起：（1）鼻内管腔水肿和变窄；（2）黏膜血管扩张；（3）清除鼻腔内的血凝块。
