急診鼻衂之臨床分析

Analysis of Epistaxis in Emergency Department

王柏哲(Po-Che Wang) ； 李國森(Kuo-Sheng Lee) ； 楊政謙(Cheng-Chien Yang)

《台灣耳鼻喉頭頸外科雜誌》 45卷2期 (2010/04) Pp. 35-39

https://doi.org/10.6286/2010.45.2.35

摘要

目的：鼻衂是常見的耳鼻喉科疾病之一，但也是耳鼻喉科急診負責醫師的挑戰，相關統計指出鼻衂的發生率與性別、年齡、氣候等因素有關，不過卻沒有台灣本土的資料佐證，因此本研究針對台灣地區急診鼻衂病例做研究探討。
方法：採病例回朔方式，自2006年3月至2008年2月於台北馬偕紀念醫院急診，收集565名主訴爲鼻衂就診於耳鼻喉科急診的患者，就性別、年齡、就診月份、相關疾病及處置作一統計分析。
結果：565名患者中，男性342名，女性223名，男女比約1.5:1。患者年齡介於8個月至86歲之間平均年齡36.5歲，以10歲爲級距做分析，可以見到以0-10歲123例最多(21.8%)，41-50歲的78例居次(13.8%)，81-90歲以上的病例數最少18例(3.2%)。求診人數月份分析以2月份的74人(13.1%)最多，4月份的28人(5.0%)最少。90名(15.93%)因車禍意外或暴力事件致鼻衂經由外科會診，34名(6.02%)有服用抗凝血劑的病史，23名(4.07%)在近1個月有接受過鼻部手術，共16名(2.8%)因鼻衂接受住院治療。
結論：本篇報告結果認爲地處亞熱帶的台灣，在男女性別比及各年齡層的分布方面，與歐美的統計大致相同，但在季節方面仍以冬季發生鼻衂機率較高。對於大部分急診鼻出血病患經由耳鼻喉科處置後都可離院後再追蹤。

關鍵字

鼻衂 ； 急診部 ； 外傷 ； 懷孕

並列摘要

BACKGROUND: Epistaxis is a frequent disease encountered by otolaryngologists. It is estimated that approximately 60% of the population will suffer from varying degrees of bleeding. Fortunately, only 6% of these people will require auxiliary medical treatment. We present our 2-year experience in epistaxis of emergency department in Taiwan.
METHODS: We reviewed the charts of 565 patients who visited emergency room for epistaxis from March 2006 to February 2008 at Mackay Memorial Hospital. Moreover, data including their genders, ages, months of the visit, and treatment were collected for further analyses.
RESULTS: There were 342 males and 223 females. Their age ranged from 8 months to 86 years, with the mean age of 36.5 years. The age-related incidence was bimodal, with among those younger than 10 years the primary peak and the age between 41 to 50 years old the secondary peak. February was the most frequent month of visit, with 74 cases (13.1%), and April was the less frequent, with 28 cases (5.0%). Among all cases, 90 patients (15.93%) had traumatic epistaxis, 34 patients (6.02%) had the history of taking anticoagulation mediation, and 23 patients (4.07%) had received nasal operation within one month. 16 patients (2.8%) were hospitalized due to uncontrollable epistaxis.
CONCLUSIONS: The frequency of epistaxis in Taiwan had no climatic difference. Besides, gender and age distribution are similar with other studies. Treatment of epistaxis in emergence department emphasizes on the maintenance of vital sign and patent airway.

並列關鍵字

epistaxis ； emergency department ； Trauma ； pregnancy