小儿鼻出血的鼻病理影响

Oğuzhan Dikici, Osman Durgut
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摘要

目的:本研究的目的是探讨鼻腔病理对儿童复发性鼻出血的影响。方法:共纳入100例(男61例,女39例)患者,年龄2 ~ 17岁,平均年龄8.9±3.6岁。所有患者均采用鼻前镜及鼻软内镜检查。记录患儿鼻出血持续时间、家长对活动性鼻出血的治疗情况、病史、治疗及干预措施。记录鼻衄部位的位置、鼻黏膜类型、有无鼻前庭炎、鼻中隔偏曲的位置和类型、腺样体大小、下鼻甲肥大程度。结果:31例(62%)复发性鼻出血患者和14例(28%)无复发性鼻出血患者存在鼻出血偏离。鼻出血组的偏差明显高于对照组(p = 0.001)。复发性鼻出血组鼻黏膜类型为脆弱型37例(74%),血管化型11例(22%),脆弱-血管化型2例(4%)。鼻出血组鼻黏膜类型与鼻黏膜年龄、鼻黏膜是否存在偏曲、鼻黏膜偏曲位置、鼻黏膜类型有显著相关性(p = 0.005, p = 0.004, p = 0.008, p = 0.015)。结论:小儿鼻出血复发与鼻中隔偏曲、下鼻甲肥大、鼻黏膜类型有关。
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Effects of Nasal Pathologies in Paediatric Epistaxis
Objectives: The aim of this study was to investigate the effects of nasal pathologies in paediatric patients with recurrent epistaxis. Methods: A total of 100 (61 boys, 39 girls) patients aged 2–17 years (mean age: 8.9 ± 3.6 years) were included in this study. Anterior rhinoscopy and flexible nasal endoscopy were used to examine all the patients. The epistaxis duration, treatment in active epistaxis by parents, medical history, medical treatment and interventions were recorded. The location of the epistaxis site, nasal mucosa type, the presence of nasal vestibulitis, nasal septum deviation location and type, adenoid size and the degree of inferior turbinate hypertrophy were recorded. Results: The deviation was present in 31 (62%) patients with recurrent epistaxis and in 14 (28%) patients without epistaxis. The presence of deviation was significantly higher in the epistaxis group than control group (p = 0.001). The nasal mucosa type was friable mucosa in 37 (74%) patients, vascularised mucosa in 11 (22%) patients and friable – vascularised mucosa in 2 (4%) patients in recurrent epistaxis group. A significant relationship was detected between nasal mucosa type and age, the presence of the deviation, deviation location, Mladina type in epistaxis group (p = 0.005, p = 0.004, p = 0.008, p = 0.015). Conclusion: Nasal septum deviation, inferior turbinate hypertrophy and nasal mucosa type are associated with paediatric recurrent epistaxis.
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