traumatic epistaxis

Introduction

Introduction to traumatic nosebleeds Traumatic epistaxis is a nosebleed caused by various external factors and is a common nasal disease. Such as deep nose, sneezing or sneezing, severe cough, nasal feeding tube and nasal foreign body friction, as well as dust, chemical stimulation, etc., can cause nosebleeds, fight, crash, all kinds of car accidents are easy Injury caused by nasal bleeding, blunt contusion in wartime, laceration, nasal and sinus fractures, nasal tissue damage, head trauma often cause severe nosebleeds, often accompanied by cerebrospinal fluid rhinorrhea, and even fatal nosebleeds. Examination of traumatic epistaxis can be performed with a posterior or optical fiber nasopharyngoscopy. Hemorrhage in the sinus, the blood often flows out from the nasal passages or olfactory. In addition to finding bleeding points, perform necessary systemic examinations (measure blood pressure, blood routine examination, bleeding time and clotting time measurement, capillary fragility test and platelet count, etc.). There is a fashion to consult with the relevant departments to find the cause. basic knowledge The proportion of illness: 0.001% Susceptible people: Most of the workers and children who work in pilots or high-pressure work. Mode of infection: non-infectious Complications: shock

Cause

Causes of traumatic nosebleeds

General trauma (23%):

Such as deep nose, sneezing or sneezing, severe cough, nasal feeding tube and nasal foreign body friction, as well as dust, chemical stimulation, etc., can cause nosebleeds, fight, crash, all kinds of car accidents are easy Injury caused by nasal bleeding, blunt contusion in wartime, laceration, nasal and sinus fractures, nasal tissue damage, head trauma often cause severe nosebleeds, often accompanied by cerebrospinal fluid rhinorrhea, and even fatal nosebleeds.

Surgical injury (12%):

Generally, due to the injury of blood vessels during surgery, it is not detected in time, or due to the failure to take effective hemostasis measures during the operation. For example, if the maxillary sinus is passed through the lower nasal passage and the posterolateral nasal artery is injured, severe arterial bleeding may occur, and the inferior turbinate may occur. Resection is particularly easy to injure the nasopharyngeal venous plexus at the posterior end of the lower nasal passage; nasopharyngeal tumor removal can damage the sphenopalatine or sinus artery; maxillary sinus radical surgery, and some bleeding occurs 6 to 7 days after surgery. The bleeding point is often in the mucosa of the edge of the hole. In the ethmoid sinus surgery, the anterior or posterior ethmoid artery is damaged, or the sphenoid sinus surgery damages the sphenopalatine artery when biting the anterior wall of the sphenoid sinus, which often causes the operation to be interrupted due to bleeding. .

Barometric injury (18%):

Frequent occurrences of pilots or high-pressure workers, such as divers and tunnel workers, or sudden changes in air pressure in the nasal cavity and sinus, can cause vasodilatation or rupture of sinus mucosa, in the case of negative pressure replacement therapy, if negative If the pressure is too large and the time is too long, the mucosal blood vessels may rupture and bleed.

Prevention

Traumatic nosebleed prevention

1. Control children's strenuous activities to avoid nasal trauma.

2. Overcome the bad habit of picking your nose.

3, diet should pay attention. Dry in autumn and winter, diet must pay attention. Children should not eat fried and fatty items, eat more fresh vegetables and fruits, and pay more water or refreshing drinks to replenish moisture. If necessary, take appropriate amounts of vitamins C, A and B2.

4, oiling to prevent nosebleeds. Nasal bleeding needs to be prevented, especially in the dry season. You can use paraffin oil, glycerin nasal drops when your child's nasal cavity is dry, or wipe the nasal cavity with cotton swabs.

5, often inexplicable nosebleed must go to the hospital for examination.

6. Prevent colds and other respiratory diseases.

Complication

Traumatic nosebleed complications Complications

There may be complications such as airway obstruction and shock.

Symptom

Traumatic nosebleed symptoms Common symptoms Nasal bleeding Nasal pain Upper nose above Defect Hypertension telangiectasia Nasal septum to one side or... Nostril exposed nose wing defect Coagulopathy Nasal septum perforation

Nasal bleeding can occur anywhere in the nasal cavity, but it is most common in the anterior and posterior segment of the nasal septum, sometimes with jet or pulsatile arterial bleeding. The posterior nasal hemorrhage often flows quickly into the pharynx and spits out from the mouth. In general, nosebleeds caused by local diseases are mostly limited to one side of the nasal cavity, and those caused by systemic diseases may alternate or simultaneously bleed on both sides of the nasal cavity.

Examine

Examination of traumatic epistaxis

No bleeding site can be found by anterior nasal examination, such as bleeding, and postoperative nasal or fiberoptic nasopharyngoscopy. Hemorrhage in the sinus, the blood often flows out from the nasal passages or olfactory. In addition to finding bleeding points, perform necessary systemic examinations (measure blood pressure, blood routine examination, bleeding time and clotting time measurement, capillary fragility test and platelet count, etc.). There is a fashion to consult with the relevant departments to find the cause.

Diagnosis

Diagnosis and diagnosis of traumatic epistaxis

After hemoptysis is bleeding from the larynx, trachea, bronchus and lungs, the blood is excreted in the mouth, which is common in tuberculosis, bronchiectasis, lung cancer, lung abscess and pulmonary congestion caused by heart disease. Can be identified according to the patient's past medical history, physical signs and auxiliary examination.

Hematemesis is one of the main manifestations of upper gastrointestinal bleeding. When a large amount of hematemesis, blood can emerge from the mouth and nasal cavity, often accompanied by other symptoms of digestive tract diseases. The whole body examination can have positive signs and can be identified.

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