老年人顽固性鼻出血的临床特征及其与高血压关系的探讨

The clinical features of refractory epistaxis in the aged and its relation to hypertension

分析１４７例由高血压诱发的老年人顽固性鼻出血，鼻出血时血压在２４．０～２６．７／１４．７～１７．３ｋＰａ８７例，≥２６．８／１７．４ｋＰａ３９例，＜２４．０／１４．７ｋＰａ２１例。发病多在寒冷季节，１１、１２月及１、２月份共占６５．３％。鼻腔后端出血占４８．９％，表现为出血凶猛、反复发生、不易止血。本组治疗过程中，当血压降低＜２．７／１．３ｋＰａ时，鼻出血减少６０例；降低２．７～５．３／１．３～２．７ｋＰａ，鼻出血又减少５７例；当血压降低≥５．４／２．８ｋＰａ时，则无鼻出血发生。并有６９例血压反跳性升高，再次发生鼻出血６０例。有效地鼻腔止血和降血压是治疗鼻出血的关键，同时给予患者心理治疗，一般不予静脉输液。

Abstract An analysis of 147 cases of refracfory epistaxis induced by hypertension in the aged showed that 65.3% of the epistaxis occurred in winter months and 69.4% in 60-69 age group. The posterior nasal bleeding occurred in 48.9%,It was severe and recurrent and not easily stanched. There existed close relationship between hypertension and epistaxis. The more near normal the blood pressure, the less the epistaxis recurred.When the blood pressure rose again, the bleeding usually recurred. Effective lowering of blood pressure and stanching in nasal cavity were the keys in treatment of the epistaxis. At the same time, the patients were given psychotherapy and usually they should not be given intravenous infusion.