François M
Service ORL, hôpital Robert-Debré, Paris, France.
Arch Pediatr. 1996 Aug;3(8):806-13. doi: 10.1016/0929-693x(96)82166-x.
Most epistaxis in children come from the anterior part of the nasal septum. The bleeding is usually under control by manual compression or vestibular packing with a piece of cotton or calcium alginate. In case of severe or recurrent epistaxis, one must look for a bleeding disorder or a nasal/nasopharyngeal tumour, especially juvenile nasopharyngeal angiofibroma in adolescent males. Chemical or electrical cautery of the septum should be suggested in case of recurrent idiopathic epistaxis. When bleeding continues despite such treatments, anterior nasal packing is recommended; life-threatening epistaxis usually requires posterior packing. Embolisation can be used to reduce blood supply before surgery in case of haemorragic tumours or vascular malformations.
大多数儿童鼻出血来自鼻中隔前部。通常通过手动压迫或用一块棉花或藻酸钙进行前庭填塞来控制出血。对于严重或复发性鼻出血，必须排查出血性疾病或鼻/鼻咽肿瘤，尤其是青春期男性的青少年鼻咽血管纤维瘤。对于复发性特发性鼻出血，建议进行鼻中隔化学或电烧灼。如果经过此类治疗后仍持续出血，则建议进行前鼻孔填塞；危及生命的鼻出血通常需要后鼻孔填塞。对于出血性肿瘤或血管畸形，在手术前可采用栓塞术来减少血供。
