Objective to investigate the causes and treatment of epistaxis in the elderly. Nosebleeds, known as "epistaxis" in medicine, are mostly caused by "lung dryness and blood heat", which leads to dry nasal cavity, insufficient toughness of capillary and rupture. If not treated in time, delayed development, will produce serious consequences, such as nasal mucosa atrophy, anemia, memory loss, poor vision, immune decline, and even cause ischemic shock, life-threatening.
The etiology of epistaxis can be divided into local etiology and systemic etiology.
Local causes: 1. Trauma; 2. Deviation of nasal septum, cristae and talus; 3. Tumors of nasal cavity, sinuses and nasopharynx.
Systemic etiology: all systemic diseases that can cause arterial or venous pressure increase, bleeding and coagulation dysfunction or vascular tension change can cause epistaxis. For example: 1, acute infectious diseases; 2, cardiovascular diseases; 3, blood diseases; 4, nutritional disorders or vitamin deficiency; 5, liver, spleen, kidney and other chronic diseases and rheumatic fever; 6, other, such as mercury, phosphorus, arsenic and other chemical poisoning, nasal mucosa by harmful gas stimulation and corrosion.
Hypertension and arteriosclerosis are common causes of epistaxis in the elderly. Because the arterial pressure increases may cause the nasal cavity the small artery to rupture, causes the nose hemorrhage. Before epistaxis, these people usually feel dizzy and have a headache. In the early morning or late at night, they suddenly bleed from one nostril, which is more powerful. Because most of them have ruptured small arteries, the blood flow is bright red. Because the elderly have more arteriosclerosis, poor retraction of blood vessels, so epistaxis is often difficult to stop, should be treated in time. When the elderly suffer from emphysema, cor pulmonale, bronchopneumonia and other diseases, they often have severe cough, which causes the increase of venous pressure and causes the rupture of blood vessels in the nasal cavity; Because of the poor gastrointestinal absorption function of the elderly, it can cause the lack of vitamin C, vitamin K or calcium, which is one of the causes of epistaxis in the elderly. In addition, epistaxis is also related to mental stimulation, long-term smoking and drinking.
Once the elderly have epistaxis, we should pay attention to the following points:
First, pay close attention to the general situation, and pay special attention to the prevention of shock caused by excessive bleeding. If the elderly epistaxis pulse fast, weak pulse, pale. We should pay special attention to the symptoms of restlessness, thirst and cold sweating. If necessary, we should go to the hospital in time for treatment.
The second is to take emergency hemostasis measures. When the elderly epistaxis; family do not panic, epistaxis occurs, the patient should take a sitting or semi lying position, head slightly forward, with the index finger and thumb pinch both sides of the nasal wings for 5 to 10 minutes, at the same time in the forehead, neck repeatedly replacement cold towel or ice bag cold compress, promote vasoconstriction, such as in the nose septum front outflow of blood, this measure can generally stop. If the bleeding is repeated or the above temporary emergency measures are ineffective, they should be sent to the hospital for treatment immediately. Epistaxis is mostly on one side. If both sides are bleeding, the first side is often the site of real bleeding; the other side flows blood from the posterior nostril. In order to stop bleeding quickly, you can take a piece of clean cotton roll into the nasal cavity, and then pinch the nose with your fingers to stop the blood. To pay attention to blocking the nose, if blood into the mouth, do not swallow, in order to avoid blood into the stomach and cause vomiting, it is not good to estimate the amount of bleeding, it is best to gently spit in the cup.
The third is to find out the reasons. Elderly epistaxis, after a little treatment at home, should go to the hospital in time to take hemostatic measures for treatment. At the same time, carry out some necessary examination, find the cause of bleeding, so as to symptomatic treatment. The elderly suffer from hypertension, arteriosclerosis or emphysema, chronic cough and other diseases, we should adhere to the treatment and prevention, which is the fundamental measure to prevent and treat epistaxis in the elderly.
Methods of prevention:
1. Quit smoking and drinking. Because alcohol and tobacco can aggravate the respiratory tract mucosa dryness.
2. Eat more vegetables and fruits. Supplement vitamin C to enhance the resistance of respiratory mucosa.
3. Pay attention to keep warm. When going out in the morning, you can wear a mask to reduce the irritation of cold air to nasal mucosa.
4. Keep nasal cavity clean. When the nasal cavity is dry and itchy, do not rub it with your hands, and use light saline to drip the nasal cavity.