Bouche J, Poncet E, Frêche C, Roulleau P, Peynègre R
Ann Otolaryngol Chir Cervicofac. 1976 Jan-Feb;93(1-2):7-13.
The authors describe their therapeutic attitude over the past few years towards severe epistaxis. In an emergency, anterior and posterior tamponage using thick tents is the main treatment used. Double balloon probes have been discontinued, in spite of the fact that they were well-tolerated, on account of the disappointing results they gave. In cases of relapse, when the posterior tampon is removed after 48 hours, systematic ligature of the sphenopalatine artery is carried out on arteriosclerosis patients aged about fifty who have high blood pressure. In other cases, the authors wait to see the effect of leaving a second tampon in place for a further 48 hours. In patients suffering from renal inadequacy, reabsorbable tents are preferable, prevention being the main aim, avoiding all treatment liable to counteract haemostasis. Generally speaking, ligature of the external carotid is often ineffective. It is the sphenopalatine artery which should be tied off (100 cases in the O.-R.L. Dept. of the Hôpital Foch). Ligature of the ethmoid is rarely indicated.
作者描述了他们在过去几年中对严重鼻出血的治疗态度。在紧急情况下，主要治疗方法是使用厚纱布条进行前后鼻孔填塞。尽管双气囊导管耐受性良好，但由于效果不佳，已不再使用。对于复发病例，在48小时后取出后鼻孔填塞物时，对于患有高血压的50岁左右的动脉硬化患者，要系统地结扎蝶腭动脉。在其他情况下，作者会等待观察再留置第二个填塞物48小时的效果。对于肾功能不全的患者，可吸收纱布条更可取，主要目的是预防，避免所有可能妨碍止血的治疗。一般来说，结扎颈外动脉往往无效。应该结扎的是蝶腭动脉（在福煦医院耳鼻喉科有100例）。很少需要结扎筛动脉。
