耳鼻喉医学-鼻的症状学

1、鼻的症状学1 。鼻塞 单侧，双侧？持续性，间歇性？程度如何？2 。鼻溢 水样鼻溢 黏液性鼻溢 黏脓性鼻溢 血性鼻溢3 。喷嚏4。鼻出血5。鼻源性头痛6。嗅觉障碍7。共鸣障碍鼻出血（epistaxis)Blood supplyEpistaxisSynonyms: nasal hemorrhage, nose bleed, bosebleed, bloody nose.Background: nosebleed is defined as acute hemorrhage from the nostril, nasal cavity, nasopharynx. In the majority of

2、 the cases, bleeding is in small quantities and self-limited, sometimes it can be very intense and life-threatening. Incidence: with peak in those aged 2-10 years and 50-80 years. No sex predilection. Climates factor: nose bleed most common occurs during colder month and in dry colder climatesEpista

3、xis常见部位: 中隔前端常见， Littles 是最常见的出血部位 后端常位于下鼻甲后端的鼻鼻咽静脉丛Epistaxis病因:局部因素： Trauma: fracture of nasal bone Infection: viral rhinitis, acute rhinitis. Foreign bodies: Deviation of the nasal septum Atmospheric change, dry climates Tumors in nasal cavity and sinuses Epistaxis全身因素： hypertension and heart dise

4、ases pregnancy Acute general infection Drugs abuse Diseases of blood system治疗原则EpistaxisTreatment:Digital press: 10 minutes Cautery: AgNO3 , laser, microwaveHardener injection: 40% ureaNasal packing: vaseline gauze, balloon glutin sponge compressed spongeEpistaxisTraditional packing:Vaseline gauze r

5、ibbon for 2448 hoursPrevent infection of sinus with antibioticAnterior pack Epistaxis The step of posterior nasal packingEpistaxis血管结扎法： 用于难以控制的，危机生命的鼻出血。常常用于颈外动脉和筛前动脉结扎。血管栓塞法：用于颈内动脉损伤造成的大出血。 EpistaxisHow to prevent rebleeding after initial bleeding has stoppedDo not pick or blow nose. Do not strain or bend down to lift anything heavy. Keep head higher than the heart. Use a humidifier during dry winter monthsA saline nasal spray will also moi