英国鼻科学会鼻出血多学科治疗指南及共识解读

Interpretation of the guidelines for multidisciplinary treatment of epistaxis of the British Academy of Rhinology

鼻出血是耳鼻咽喉科常见急症之一,发病率较高,我国于2015年制定了鼻出血治疗指南⑴,已成为临床医生在鼻出血诊疗过程中的重要依据。英国于2016年也制定了鼻出血治疗指南⑵,2017年就指南内容进行了深入的讨论和探究并达成共识⑶。我国和英国关于鼻出血的治疗指南均从初步评估、烧灼术、鼻腔填塞、血液系统因素、手术治疗及介入治疗5个方面对鼻出血的治疗进行指导。本文对上述2个重要指南及共识进行解读,以期为我国鼻出血治疗指南的制定提供帮助。

Epistaxis is a common condition that can be associated with significant morbidity, and it places a considerable burden on our healthcare system. In China, a draft guidelines for diagnosis and treatment of epistaxis was released in 2015. In UK, a national audit of management for epistaxis was promulgated in 2016, followed by multidisciplinary consensus recommendations on the hospital management of epistaxis in 2017. Here, we compared the management of diagnosis and treatment for epistaxis between China and UK in five clinical aspects, including initial assessment, cautery, intranasal agents, antithrombotic therapy and hematological factors, as well as surgery and radiological intervention. The results demonstrate that the management recommendations in UK combined a wide-ranging review of the relevant literature with established and rigorous methods of guideline generation, while the guidelines in China is more specific on the procedures of diagnosis and treatment for epistaxis. The current discussion provides perspectives to improve the guidelines for epistaxis in China.