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Abstract：
BACKGROUND: Delayed epistaxis after endoscopic transnasal pituitary tumor resection (ETPTR) is a critical complication, tending to cause aspiration or hemorrhagic shock. This study assessed clinical characteristics, risk factors, and provide treatment and prevention advice of this complication.
METHODS: This was a retrospective monocentric analysis of 862 patients who underwent ETPTR. Statistical analyses of clinical data revealed the incidence, sources and onset time of delayed epistaxis. Univariate analysis and binary logistic regression were used to identify risk factors.
RESULTS: The incidence of delayed epistaxis was 2.78% (24/862), with an average onset time of 20.71 ± 7.39 days. The bleeding sources were: posterior nasal septal artery branch of sphenopalatine artery (12/24), multiple inflammatory mucosae (8/24), sphenopalatine artery trunk (3/24) and sphenoid sinus bone (1/24). Univariate analysis and binary logistic regression analysis confirmed that hypertension, nasal septum deviation, chronic rhinosinusitis and growth hormone pituitary tumor subtype were independent risk factors for delayed epistaxis. Sex, age, history of diabetes, tumor size, tumor invasion and operation time were not associated with delayed epistaxis. All patients with delayed epistaxis were successfully managed through endoscopic transnasal hemostasis without recurrence.
CONCLUSIONS: Delayed epistaxis after ETPTR tends to have specific onset periods and risk factors. Prevention of these characteristics may reduce the occurrence of delayed epistaxis. Endoscopic transnasal hemostasis is recommended as the preferred treatment for delayed epistaxis.
METHODS: This was a retrospective monocentric analysis of 862 patients who underwent ETPTR. Statistical analyses of clinical data revealed the incidence, sources and onset time of delayed epistaxis. Univariate analysis and binary logistic regression were used to identify risk factors.
RESULTS: The incidence of delayed epistaxis was 2.78% (24/862), with an average onset time of 20.71 ± 7.39 days. The bleeding sources were: posterior nasal septal artery branch of sphenopalatine artery (12/24), multiple inflammatory mucosae (8/24), sphenopalatine artery trunk (3/24) and sphenoid sinus bone (1/24). Univariate analysis and binary logistic regression analysis confirmed that hypertension, nasal septum deviation, chronic rhinosinusitis and growth hormone pituitary tumor subtype were independent risk factors for delayed epistaxis. Sex, age, history of diabetes, tumor size, tumor invasion and operation time were not associated with delayed epistaxis. All patients with delayed epistaxis were successfully managed through endoscopic transnasal hemostasis without recurrence.
CONCLUSIONS: Delayed epistaxis after ETPTR tends to have specific onset periods and risk factors. Prevention of these characteristics may reduce the occurrence of delayed epistaxis. Endoscopic transnasal hemostasis is recommended as the preferred treatment for delayed epistaxis.
摘要：
背景：内镜经鼻垂体瘤切除术（ETPTR）后迟发性鼻出血是一种严重的并发症，容易引起误吸或失血性休克。这项研究评估了临床特征，危险因素，并提供这种并发症的治疗和预防建议。
方法：这是862例接受ETPTR的患者的回顾性单中心分析。临床数据的统计分析显示了发病率，迟发性鼻出血的来源和发病时间。采用单因素分析和二元logistic回归分析确定危险因素。
结果：延迟性鼻出血的发生率为2.78％（24/862），平均起效时间为20.71±7.39天。出血来源为：蝶窦动脉后鼻中隔动脉分支（12/24），多发性炎症粘膜（8/24），蝶腭动脉干(3/24)和蝶窦骨(1/24)。单因素分析和二元logistic回归分析证实，高血压，鼻中隔偏曲,慢性鼻-鼻窦炎和生长激素垂体肿瘤亚型是迟发性鼻出血的独立危险因素。性,年龄,糖尿病史,肿瘤大小,肿瘤浸润和手术时间与迟发性鼻出血无关。所有迟发性鼻出血患者均通过内镜经鼻止血成功治疗，无复发。
结论：ETPTR后迟发性鼻出血倾向于有特定的发病时间和危险因素。预防这些特征可以减少迟发性鼻出血的发生。建议内镜经鼻止血作为迟发性鼻出血的首选治疗方法。
方法：这是862例接受ETPTR的患者的回顾性单中心分析。临床数据的统计分析显示了发病率，迟发性鼻出血的来源和发病时间。采用单因素分析和二元logistic回归分析确定危险因素。
结果：延迟性鼻出血的发生率为2.78％（24/862），平均起效时间为20.71±7.39天。出血来源为：蝶窦动脉后鼻中隔动脉分支（12/24），多发性炎症粘膜（8/24），蝶腭动脉干(3/24)和蝶窦骨(1/24)。单因素分析和二元logistic回归分析证实，高血压，鼻中隔偏曲,慢性鼻-鼻窦炎和生长激素垂体肿瘤亚型是迟发性鼻出血的独立危险因素。性,年龄,糖尿病史,肿瘤大小,肿瘤浸润和手术时间与迟发性鼻出血无关。所有迟发性鼻出血患者均通过内镜经鼻止血成功治疗，无复发。
结论：ETPTR后迟发性鼻出血倾向于有特定的发病时间和危险因素。预防这些特征可以减少迟发性鼻出血的发生。建议内镜经鼻止血作为迟发性鼻出血的首选治疗方法。
