鼻出血489例の検討

抄録

We investigated the data of 489 patients with epistaxis who visited our hospital between 2009 and 2013. Epistaxis was more frequent in males (298 cases) than in females (191 cases).
The mean age was 57.1 years, with the largest number of patients were in their 70s, 60s and 50s, in that order. Epistaxis occurred more often in the winter and spring, with a significantly lower number of patients in the summer and autumn. The most frequent onset time was in the morning from 6 am to 8 am. The sites of bleeding were Kiesselbach’s area (50.7%), followed by unidentifiable site (25.2%), nasal septum (11.5%), inferior meatus and turbinate (7.4%), and middle meatus and turbinate (3.7%). Of all the patients, 42.7% were treated by electrical coagulation with or without a rigid endoscope, 40.5% were managed by observation, and 16.6% by gauze packing. Of the 489 patients, 48 (9.8%) required hospitalization, and re-bleeding occuered in 64 (13.1%) cases. The major underlying disease was hypertension (32.5%), while 25.8% of all cases were receiving anticoagulant therapy.
It is most important to identify the bleeding site by flexible fiberoptic and/or rigid endoscopy. Electrical coagulation with a rigid endoscope was a very useful procedure in the treatment of epistaxis, especially that occurring from the posterior part of the nasal cavity.