Bleeding from the front of the nose
Introduction
Introduction Nasal bleeding is a common symptom of otolaryngology, more than 80% of which is bleeding in the front of the nose, and bleeding in the front of the nose is easier to handle. Children's nosebleeds occur almost entirely in the front of the nose; young people have more common bleeding in the front of the nose, and a few severe bleeding occurs in the back of the nose. In childhood, there are often some infectious diseases with high onset and high fever, especially upper respiratory tract infections. In addition, trauma, nose digging, nasal foreign bodies, blood diseases, chronic rhinitis and paranasal sinusitis can also be caused.
Cause
Cause
According to analysis, the causes of children's nosebleeds are roughly as follows:
1. Acute febrile infectious diseases: In childhood, there are often some infectious diseases with acute onset and high fever, especially upper respiratory tract infections. When high fever occurs, the skin and mucous membranes of the whole body become congested and swollen, and the pathological changes occur in the nasal mucosa. Acute congestion and swelling of the nasal mucosa are more likely to cause rupture and bleeding, because the nasal mucosa is superficial, and once it is severely heated, it is added. Under the external force of the forceful nose, the submucosal blood vessels will rupture and bleed.
2, trauma: The nose is an organ exposed to the body surface, once a trauma, such as blows, falls, the nose naturally bear the brunt. Under the impact of severe trauma, the blood vessels under the mucosa will rupture and bleed.
3, digging the nose: Strictly speaking, the nose should also be included in the scope of trauma. Out of curiosity and discomfort, children often like to use their fingers to blindly dig in the nasal cavity. This is a bad habit that is neither hygienic nor easily causes local mucosal bleeding in the nasal cavity. Generally, the part of the nose is placed in front of the nasal septum, and there are many blood vessels in this part. Many tiny blood vessels are intertwined into a plexus, which is like a spider web. The blood vessels are both superficial and very thin, and the parts are in the nasal cavity. As soon as the hand is dug, the blood vessels can be broken. More than 90% of children with epistaxis are here.
4, nasal foreign body: Usually, in addition to some secreted nasal discharge in the nasal cavity, there is no object blocking the nasal cavity, so that breathing is free and smooth. But sometimes, children are fond of playing things, like to put some small objects in the nasal cavity, such as peanuts, melon seeds, fruit cores, soybeans, plastic paper, metal toys and so on. Once these objects are stuffed into the nose and become foreign objects, the children can't take them out, and they don't dare to speak. After a long time, they are forgotten and left in the nasal cavity. Some foreign bodies swell and mold in the nasal cavity, causing nasal mucosal infection, erosion and bleeding. Sometimes, under the bad stimulation of foreign bodies, the nasal mucosa can also cause traumatic bleeding.
5, blood diseases: It is necessary to know that the blood in the blood vessels of the human body should be neither bleeding nor agglutination, which is determined by some special factors in the blood. If under certain factors, some factors in the blood will undergo a series of changes, so that after the bleeding of blood vessels and blood, it is not easy to agglutinate. I wish that these diseases have white blood and blood and thrombocytopenic purpura, regeneration. Obstructive anemia, etc., collectively referred to as blood glass, is the cause of children's nosebleeds directly, and can cause repeated, massive bleeding.
6, rhinitis, paranasal sinusitis: children are also prone to acute, chronic rhinitis and paranasal sinusitis. Once this inflammation occurs, the mucous membranes in the nasal cavity or paranasal sinus are congested and swollen, and from time to time there is a purulent nasal discharge. Under the stimulation of purulent nasal discharge, blood vessels under the mucosa may also bleed.
Examine
an examination
Related inspection
Nasal endoscopy
Basic inspection:
1. Front nose examination.
2. X-ray films clearly have no sinus infection.
Further examination:
1. Nasal secretion smear to detect pathogenic bacteria.
2. Nasal secretions bacterial culture + drug sensitivity.
3. If necessary, virus inspection requires special cultivation, separation and identification.
Diagnosis
Differential diagnosis
Differential diagnosis of anterior nasal bleeding:
Posterior hemorrhage in the nasal cavity: There are many causes of nosebleeds, and the bleeding site in the posterior part of the nasal cavity is more common in middle-aged and elderly people over 40 years old, mostly related to hypertension. According to reports: the incidence of high blood pressure in nosebleeds accounted for 10% to 25%. Hypertension is also the most important independent risk factor for stroke.
Most of the nosebleeds occur on one side. If both nostrils are found to have blood, the blood in one side of the nasal cavity will flow backwards, and the posterior nostrils will flow back to the opposite side. Most of the bleeding sites and the easy bleeding area in the anterior and posterior part of the nasal septum. Seen in children and most young people.
