Epistaxis (nosebleed) Etiology: 1、 Local causes: 1) Trauma: mucosa laceration blood vessel injur 2) Inflammation of nose and sinus 3) Diseases of septum 4) Tumor: nasal cavity tumor sinus tumor angiofibroma of nasopharynx
Epistaxis (nosebleed) Etiology： 1、 Local causes： 1）Trauma：mucosa laceration blood vessel injury 2）Inflammation of nose and sinus 3）Diseases of septum 4）Tumor：nasal cavity tumor sinus tumor angiofibroma of nasopharynx
2、 General factors Systematic disease Ascension of arterial pressure and venous pressure, sfunction of coagulation Change of blood vessel tension
2、 General factors Systematic disease—— Ascension of arterial pressure and venous pressure， Dysfunction of coagulation, Change of blood vessel tension
1) Acute epidemical diseases 2) Cardiovascular diseases 3) Hemological diseases 4) Nutrition defect:VitC、K、 P or calciun 5) Liver, kidney diseases and rheumatic fever 6) Poison: phosphorus, mercury, arsenic, benzene 7 Osler's disease hemorrhagic familial telangiectasia 8) Endocrinic imbalance
1） Acute epidemical diseases 2） Cardiovascular diseases 3） Hemological diseases 4） Nutrition defect：VitC、K、P or calcium 5） Liver, kidney diseases and rheumatic fever 6） Poison ：phosphorus, mercury, arsenic, benzene 7） Osler’s disease hemorrhagic familial telangiectasia 8） Endocrinic imbalance
TTreatment 1 Fundamental treatment Emergency sedation estimate the bleeding amount keep proper posture No blood ingest 2、 Hemostatic methods 1)Identify the bleeding site pinch the nostrils
Treatment： 1、 Fundamental treatment Emergency: sedation estimate the bleeding amount keep proper posture No blood ingest 2、 Hemostatic methods 1）Identify the bleeding site pinch the nostrils
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2) Cautery techniques chemical electrical ● laser ° radiofrequency ● microwave 3) Nasal packing resorbable material, gel foam anterior postorior water or air balloon
2）Cautery techniques • chemical • electrical • laser • radiofrequency • microwave 3） Nasal packing • resorbable material, gel foam. • anterior • postorior • water or air balloon
3、 Artery ligation anterior ethmoid arter posterior ethmoid artery internal maxillary artery external carotid artery 4, Angiography and embolization submucous resection endoscopic cautery and ligation
3、Artery ligation anterior ethmoid artery posterior ethmoid artery internal maxillary artery external carotid artery 4、 Angiography and embolization submucous resection endoscopic cautery and ligation
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5 Systematic management 1 sedative 2) hemostatic agent 3) Vitamine C. K 4) sclerosant 5) anti-shock management 6 Traditional chinese medicine
5、 Systematic management. 1） sedative 2） hemostatic agent 3） Vitamine C, K. 4）sclerosant 5） anti-shock management 6）Traditional Chinese Medicine
Foreign body in the nose Endogenic Dead bone. blood clot. rhinolith Estrogenic Plant seeds. insect. metals. stone. woods Biologic Nonbiologic
Foreign body in the nose Endogenic Dead bone, blood clot, rhinolith Extrogenic Plant seeds, insect, metals, stone, woods… Biologic Nonbiologic