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Epistaxis
鼻衄
What is Epistaxis?
鼻衄是什么？
Bleeding from inside the nose is also known as Epistaxis.
鼻内出血也称为鼻衄。
Why does it occur?
为什么会发生这种情况呢？
There are many different reasons.
有很多不同的原因。
Most important ones are- Among children due to trauma due to nasal picking.
最重要的是，对于儿童来说经常因为挖鼻孔造成创伤。
Another important cause in children is foreign body in nose.
儿童鼻衄的另一个重要原因是鼻内异物。
- Infections of nose, - Deviated Nasal Septum, - Raised blood pressure, - Kidney disease and liver disease.
鼻感染，鼻中隔偏曲，血压升高，肾脏疾病和肝脏疾病。
What are the sites of Epistaxis?
鼻衄位置在哪？
1.Most important site of epistaxis in nose is Little's area. In 90% of cases, Epistaxis occurs from here.
1.鼻出血最重要的部位是利特尔区。在90%的病例中，鼻出血都是从这里发生的。
It is situated in antero-inferior part of Nasal Septum.
它位于鼻中隔前下部。
Four Arteries: anterior ethmoidal, septal branch of superior labial, septal branch of sphenopalatine and the greater palatine arteryanastamose here.
四支动脉：筛前动脉、上唇隔膜分支、蝶腭隔膜分支和腭大动脉。
2.Posterior part of nasal cavity. After bleeding from here blood flows directly into pharynx.
2. 鼻腔后部：鼻腔后部出血后，血液直接流入咽部。
Diffuse: It is bleeding from septum and lateral wall. This is often seen in general systemic disorders and blood dyscrasias.
弥漫性：鼻中隔和侧壁出血。这通常发生于全身疾病和血液病患者身上。
How will you manage a case of Epistaxis?
如何处理鼻出血病例？
In any case of epistaxis, it is important to ask the patients: 1) Mode of onset. Was it spontaneousor was there finger nail trauma?
在任何情况下鼻出血，重要的是要问患者：1）发作方式，是自发性的还是有手指指甲损伤导致的？
2) Duration and frequency of bleeding. 3) Amount of blood loss.
2）出血的持续时间和频率。3）出血量。
4) Side of nose from where bleeding is occurring or is it occuring from both sides of nose?
4）出血是从鼻子的一侧开始还是鼻子的两侧都出血？
5) Any known bleeding tendency in patient or family?
5）患者或家属有已知的出血倾向吗？
6) Any history of drug intake? Analgesics? Anticoagulants etc.
6）有吸毒史吗？是否使用止痛药、抗凝剂等等。
How will you treat epistaxis?
如何治疗鼻出血？
1.First Aid. Most of time, bleeding occurs from Little's areaand can be controlled by pinching nose with thumb and index for 5 minutes. This compresses blood vessels of Little's area.
1. 急救护理。大多数情况下，出血发生在利特尔区，用拇指和食指捏鼻子5分钟，可以压迫利特尔区的血管，可以控制出血。
2.Cauterisation. Useful in patients where bleeding point has been located.
2. 电疗对已定位出血点的患者很有用。
3.Anterior Nasal Packing.
3. 前鼻腔填塞。
4.Posterior Nasal Packing
4.后鼻腔填塞。
General Measures
一般措施
1.Make the patient sit up.
1.让病人坐起来。
2.Reassure the patient.
2.让病人放松。
3.Keep check on pulse and BP.
3.持续监测脉搏和血压。
