고령 환자에서 발생하는 재발성 비출혈의 특성과 위험요인에 대한 연구

김소정; 이소정; 고유진; 박솔; 배정호

doi:https://doi.org/10.3342/kjorl-hns.2020.00850

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자료유형: 학술저널

저자정보: 김소정 (이화여자대학교) 이소정 (이화여자대학교 의과대학 이비인후과학교실) 고유진 (이화여자대학교 의과대학 이비인후-두경부외과학교실) 박솔 (이화여자대학교 목동병원 이비인후과) 배정호 (이화여자대학교)

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후-두경부외과학회지 제64권 제8호

발행연도: 2021.8

수록면: 548 - 553 (6page)

DOI: https://doi.org/10.3342/kjorl-hns.2020.00850

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Background and Objectives Recurrent epistaxis requiring emergency department (ED)visits results in increased morbidity in the elderly and associated with high health care costs. This study is to analyze the frequency and characteristics of epistaxis patients in the elderlyand to find out the risk factors and effective treatment for recurrent epistaxis. Subjects and Method We studied retrospectively the clinical cases of 977 emergency patientsand 155 patients, aged over 65, for the treatment of epistaxis during the last 10 yearsfrom January 2008 to January 2018. The group A, comprised of 95 patients (68.29%), wastreated with an initial treatment. The group B, which comprised of 60 patients (38.71%), visitedfor re-bleeding following an initial treatment. Results Patients made 2 to 10 ED visits due to re-bleeding and 32 of the 60 patients (53.5%)visited twice. The electrocauterization was the most common (61.7%) for treatment methodduring rebleeding, followed by posterior packing (18.3%). The factors that increases the riskof recurrent epistaxis are anticoagulants, posterior epistaxis, anterior packing, inefficient EDpacking. There was no correlation between comorbidities and rebleeding. Conclusion Accurate medical history taking of anticoagulants may enable personnel to providemore effective management of these patients. The most important factors in the failure ofprimary care were not being able to find the precise area of bleeding and ineffective packingduring the initial treatment. Therefore, it is important that we must carefully check the areasusing the endoscope to decrease the failure of initial treatment of epistaxis.

#Anticoagulants #Epistaxis #Geriatrics #Risk factors.

참고문헌 (19)

참고문헌 신청

Gede LL / 2013 / National long-lasting effect of endonasal endoscopic sphenopalatine artery clipping for epistaxis / Acta Otolaryngol 133(7):744~748

Christensen NP / 2005 / Arterial embolization in the management of posterior epistaxis / Otolaryngol Head Neck Surg 133(5):748~753

Cooper SE / 2012 / Direct cauterization of the nasal septal artery for epistaxis / Laryngoscope 122(4):738~740

Nair KK / 1982 / Transantral ligation of the internal maxillary artery / Laryngoscope 92(9 Pt 1):1060~1063

Passey JC / 2003 / Internal maxillary artery ligation for idiopathic intractable epistaxis / Indian J Otolaryngol Head Neck Surg 55(1):51~52

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