METHODS: The patients were divided into two groups: patients with epistaxis successfully controlled in outpatient department (OPD) and those with intractable epistaxis in OPD which was controlled by surgical exploration or arterial embolization (OP/EM). Evaluations of the bleeding locations, related vessels, and patient\'s comorbidities were conducted.
RESULTS: A total of 41 patients from the OP/EM group and 725 patients from the OPD group were enrolled. The following comorbidities showed elevated risks of the intractable epistaxis (p< 0.05) in multivariate analysis; hypertension (OR 1.089, 95% CI 1.049 - 1.132), dyslipidemia (1.132, 1.041 - 1.232), liver cirrhosis (1.272, 1.152 - 1.406), chronic obstructive pulmonary disease (1.234, 1.078 - 1.412) and asthma (1.205, 1.053 - 1.379). Inferior and middle turbinate were equally the most common location of the intractable bleeding.
CONCLUSIONS: In patients with epistaxis requiring hemostatic treatments, comorbidities such as hypertension, dyslipidemia, liver diseases, COPD, and asthma were associated with intractable epistaxis. The main bleeding sites of intractable epistaxis were the middle and inferior turbinate.
方法:将患者分为两组:门诊(OPD)成功控制的鼻出血患者和通过手术探查或动脉栓塞(OP/EM)控制的OPD顽固性鼻出血患者。出血部位的评估,相关船只,并进行了患者的合并症。
结果:共纳入41例OP/EM组和725例OPD组患者。以下合并症在多变量分析中显示顽固性鼻出血的风险升高(p<0.05);高血压(OR1.089,95%CI1.049-1.132),血脂异常(1.132,1.041-1.232),肝硬化(1.272,1.152-1.406),慢性阻塞性肺疾病(1.234,1.078-1.412)和哮喘(1.205,1.053-1.379)。下鼻甲和中鼻甲同样是顽固性出血的最常见位置。
结论:需要止血治疗的鼻出血患者,合并症如高血压,血脂异常,肝脏疾病,COPD,哮喘与顽固性鼻出血有关。顽固性鼻出血的主要出血部位为中鼻甲和下鼻甲。