Nasal bleeding (bleeding from the nose). Causes of bleeding from the nose One-sided bleeding from the reason

(academic - epistaxis) is a very common pathology in humans. With it, there is a discharge of blood from the nasal cavity due to the rupture of blood vessels. In some cases, Epistaxis leads to a large blood loss and even threatens life. In 20% of such bleeding requires immediate help of a doctor. The nasal mucosa is featured by the presence of a significant amount of small blood vessels. When damaged, blood flows out of the nostrils outside, but in severe cases it can flow into the larynx and interfere with breathing. Most often, damage to vessels is random when the nasal is injured.

According to statistics, Epistaxis is celebrated in 60% of people. Usually nasal bleeding occurs in children under 10 years and in adults after 50 years. It is noteworthy that this pathology is more characteristic of men.

After 40-50 years of bleeding from the nose appear more often, since the mature people have a mucous membrane, much land and thinner than in young age. In this case, the ability of blood vessels to the reduction is reduced, and a tendency to the progression of arterial hypertension is observed. In 80% of cases, with obscure causes of frequently repetitive nasal bleeding, the patient detect problems in the hemostasis system (the hemostatic system).

Specialists distinguish between two types of such bleeding, depending on which departments of the nasal cavity they occur:

Front, which occurs most often. With it, blood flows out of the nostrils outward;

The rear, which is rare, but represents a significant health danger and requires medical care. With it, blood flows on the nasopharynx inside.

Causes of nasal bleeding

This pathological condition is caused by various reasons, but two groups of factors leading to nasal bleeding are distinguished.

Local damage that are the most common cause of bleeding from the nose:

Nose injury during sports or accident;

Operational intervention, for example, rhinoplasty;

Intervention of foreign objects, including fingers;

Reduced air humidity (especially in winter), leading to the cut of the nasal mucosa;

Barotravma;

Use oxygen catheter.

Systemic reasons that are less common, but require close attention of the doctor:

Allergy;

Various infectious diseases: ORZ, ARVI, accompanied by intoxication of the body. Toxins, viruses and bacteria lead to the expansion of blood vessels that become thin and fragile. Against the background of infections, there is a weakening of blood clotting processes and an increase in the permeability of its elements;

Diseases of vessels, including;

Blood diseases: leukemia, capillaryotoxicosis, hemoblastosis, hemophilia, hemorrhagic, Randu-Osler's disease, Vergood, Willebrand;

Disadvantage in the body of vitamins K, C;

Pathological liver conditions: hepatitis and cirrhosis, which lead to a decrease in the synthesis of components affecting the normal functioning of the bloodstream system. At the same time, the structure of the hepatic tissue is changed, which causes a slowdown in blood flow and increase blood pressure in those vessels that are responsible for renal blood circulation;

Abuse of alcoholic beverages causing vascular expansion;

Angofibrome, which is an education localized in the nasopharynk or at the base of the skull. It is characterized by frequent nose bleeding;

Kidney diseases that provoke blood pressure growth;

Hypothyroidism, expressed in violation of the function of the thyroid gland, in which the production of platelets is reduced;

Side effect of drugs.

In 90-95% of the cases of Epistaxis, its source is an edging department of the nasal partition, called kitoselbach plexus. In other cases, bleeding is developing on the middle and rear sections of the nasal cavity. The most threatening are epistaxis, characterized by a sudden beginning, a large loss of blood and shortness. Specialists call them "signal" epistaxis. They may be caused by damage to the large vessel in the nasal cavity or the gap of the aneurysm. Nasal bleeding can provoke and cancer tumor.

Lonantic bleeding, which is characterized by the appearance of scarlet foamy blood, can also occur through the nose. When bleeding arising in the upper gastrointestinal departments, dark curved blood can be highlighted from the nose. Blood diseases and anticoagulant treatment often cause this pathological condition and increase its duration. Epistaxis is also one of their signs of a skull fracture. Often, in the same time, white spins of the spinal fluid are observed in the blood. The heat or solar blow can also cause blood flow from the nose. At the same time it is accompanied by nausea ,. This state may even be subject to healthy people.

In cases where the exact cause of epistaxis is not established, it is usually associated with blood diseases. Moreover, it can be a number of serious diseases. These include violations of the function and the structure of platelets, a decrease in blood coagulation factors and a decrease in prothrombin. The reasons leading to nasal bleeding are also high physical exertion, quick running, body overheating, sharp slopes and upload at high pressure, surrounding air.

To establish the cause of chronic nose bleeding, the following laboratory and hardware studies may be needed:

Blood test and urine, which will show the general health condition;

Coagulogram, which characterizes the work of the blood coagulation system;

Blood test for the presence of prothrombin and the definition of liver pathologies, asat;

Electroencephalogram, reflecting the nature of the biotok of the brain;

Ultrasound heads and internal organs;

An electrocardiogram indicating violations in the work of the cardiovascular system;

Echocardiography aimed at the study of changes in the heart and its valves;

Radiograph of the nasal cavity and cranial box;

Computed tomography of the sinuses of the nose;

Magnetic resonance imaging of nasal sinuses and cranial boxes.

To establish a diagnosis, the patient may be needed by the following doctors: ENT, hematologist, surgeon, neuropathologist, cardiologist, oculist.

High pressure bleeding at high pressure

Increased pressure is considered one of the frequent causes of nasal bleeding. Its first signs are:

Pulsating headache;

Nausea and general weakness.

Frequent cases of nasal bleeding accompanied by the above features indicate a hypertensive disease. In this case, the appearance of blood from the nose is a kind of compensatory process that prevents overload of the brain vessels. Bleeding from the nose arising from arterial hypertension is characterized by a large duration. Abundant bleeding from the nose at high pressure can lead to its rapid drop, which can provoke acute heart failure (collapse).

What is the reason for frequent nasal bleeding?

Often repeating nose bleeding are often associated with the features of the anatomical structure of the nasal cavity. The appearance of droplets or blood pips with cough, sneezing, cold or with normal well-being testifies to the weak walls of the vessels of the plexus Kiselbach. Such bleeding from the nose is almost always observed from an early age.

Another reason for frequent spontaneous nose bleeding is atrophic rhinitis. In this case, the disease mucosa of the nose becomes fine and dry. Its condition contributes to the disruption of the integrity of blood vessels at the slightest touches.

Frequent epistaxes are marked with a change in hormonal background. They can occur in adolescence and in pregnant women. For girls from 11 years old, the discharge of blood from the nose is sometimes noted. They can accompany the first menstruation for some time. During pregnancy in the body, global hormonal, structural and functional changes occur. He strongly increases the level of sex hormones, such as estrogens and progesterone. They have a direct impact on the increase in blood flow in the zone of mucous membranes. At the same time, women having fragile vessels or a thin mucous membrane of the nose significantly increases the risk of frequent epistaxis. Sometimes pregnant women have bleeding from the nose indicate an increase in blood pressure, which is a sign of the development of such hazardous states as preeclampsia and eclampsia. Also, the emergence of epistaxis can testify to the exacerbation of a pregnant woman of kidney and liver diseases.

Regardless of the reasons, private epistaxis are a significant reason for consulting a physician and conducting a comprehensive diagnosis of human health.

What to do with nasal bleeding?

For most people, the following characteristic sensations are noted in front of the beginning of nosebleed bleeding: increasing headache, pulsating noise in the ears, feeling of tickling or in the nose. Actions with such pathology directly depend on the factors that caused it. It should also take into account the severity of pathogenesis.

Experts allocate the following typical signs of bleeding from the nose:

Allocation from the nostril or expiration in the throat of scarlet blood testifies that its source is the front or rear body of the nasal cavity;

The outflow of foamed blood from the nose is a sign of pathology in the lower departments of the respiratory organs, namely - in bronchi and lungs;

Minor bleeding, characterized by the release of drops and blood pips. As a rule, their volume does not exceed several milliliters. It usually ceases independently and is very short. To stop such epistaxis, you just need to press the wings of the nose. Most often, such pathology is formed in the field of plexus Kiselbach;

Moderate bleeding, which leads to a loss of up to 300 ml of blood. Despite this, pathological changes in the cardiovascular system most often do not occur. It is advisable to consult a doctor for studying the causes of Epistaxis;

Strong blood loss (300-500 ml), causing the pallor of the skin, decrease in blood pressure to 110-70 mm RT. Art., general weakness, significant increase in pulse (up to 90 ice / min.), dizziness. In the most difficult cases, the patient loses up to 1 liter of blood. After such a bloodsture after 1-2 days, hemoglobin levels often drops. The hematocrit with such an epistaxis decreases to 30-35 units. Abundant nose bleeding is a serious threat to human health, so it is necessary to refer to the doctor without delay.

Not always bleeding from the nose can be stopped independently. In this case, medication treatment can be applied. Under it, the patient is prescribed blood-and-standing drugs intravenously / intramuscularly or inside. They are chosen depending on the severity of bleeding. With minor and moderate epistaxis, 1-2 h. Spoons of 10% calcium chloride. It enhances the effect of bloodstream drugs, improves the reduction of vessel walls and reduces their permeability.

Doctors to stop epistaxis prescribe the following drugs:

Sodium etching solution 12.5% \u200b\u200b(dicinone), which enhances the platelet function and contributes to stopping bleeding. It does not affect blood clotting, so it is prescribed for a long time. It is used to receive inside or intravenously;

Vikasol, which enhances the effect of bloodstand drugs, but it cannot be used more than 3-4 days. This drug is injected intramuscularly;

Aminocaprochic acid that reduces processes leading to blood dilution. It is injected intravenously (more than 60 drops per minute). This means is contraindicated in the DVS syndrome (violation of intravascular coagulation), since it enhances blood coagulation.

The patient should also take vitamins C and K. When severe nasal bleeding, blood components are transfused. The patient is introduced at least 500 ml of fresh plasma with a hemostatic effect.

With incessant long-term time bleeding from the nose, surgical treatment methods can be applied.

Front tamponada

The front tamponade, at which bleeding stops from the front department of the nasal cavity, is made like this:

During the procedure, the area of \u200b\u200bthe nose is anesthetized by an aerosol 10% solution of lidocaine or instillation of 2% of dicaine.

The nostril is injected with a gauze tampon (Turundum) up to 20 cm long and a width of up to 1.5 cm.

Before administering into the nose, Turund is wetted with 3% hydrogen peroxide, accelerating blood clotting, or a 5% solution of aminocaproic acid with a hemostatic effect.

Turund can also be watched by thrombin or hemophobine.

After the introduction of a tampon on the nose impose a prazewood bandage.

Turundum in the nose is left for 1-2 days, daily injected with aminocaproic acid into Tampon. In particularly severe cases, tours in the nose are left for 6-7 days.

Before removing the tampon, 3% of hydrogen peroxide is injected into it so that it becomes wet and easier to be easier.

Rear tamponada

The rear tamponade, necessary for strong bleeding from the rear bodily cavity, is made as follows:

For this procedure, sterile tampons are prepared from folded gauze. Their size should be 2.5x2 cm.

The tampon is tied up with two silk threads of 20 cm long crosswise. One of the four ends of the threads cut off.

The procedure produces an intramuscular anesthesia to a lithic mixture consisting of aqueous solutions of 1 ml of 1% priedol, 2 ml of 50% analgin, 1 ml of 2% of DIMEDROL.

Begin the procedure from introducing a thin rubber catheter to the bleeding nostril. It is introduced until it comes out through the nasopharynx in the throat.

Then, with the help of forceps or tweezers, the catheter is pulled out through the mouth outward.

By the end of the catheter, tampon ties and tighten it inside the nasal cavity until he stops at Hoan (internal nasal holes).

The tampon is held in place with the help of two stretched threads emerging their nasal hole.

The third thread is derived from the mouth. It is glued to the cheek with adhesoplasty.

Rear tamponad for reliability complement the front.

Tampons are left in the nose for 1-2 days. In severe cases - for 6-7 days. The patient must take antibiotics and sulfonamide drugs for the prevention of infectious diseases and rhinogenic sepsis.

Remove tampons with silk threads.

Operational intervention is applied in 5-17% of cases of permanent extensive nose bleeding.

In this case, it is possible to affect the nasal cavity by the following methods:

Cutting a circular swag swab, moistened with a 40% solution of Lyapis (silver nitrate) or trichloroacetic acid. This is the easiest method of epistaxis therapy. After such a procedure, a crust is formed, stopping blood release;

The introduction of drugs (novocaine, lidocaine) into the submucosal shell of the nasal cavity. Such a method of therapy is used at local bleeding;

Floature resection of cartilage, in the nasal partition, detachment of the nasal mucosa and local interventions recommended with frequent pathology relapses;

Electro-mapping (current cave), which should be performed only in a medical institution. The procedure is carried out during local anesthesia. Electro-generation well helps in damage to the small vessels of the front septum of the nasal partition and recurrent bleeding;

Radio-wave impact of a Surgitron device, which is characterized by its efficiency and safety. This surgical intervention has no virtually no side effects and complications;

Cryodestruction, during which the damaged section of the mucous membrane is treated with liquid nitrogen. After such therapy on the mucous membrane, the scar tissue does not occur. In this case, the mucous membrane is quite quickly restored completely. The procedure lasts about half an hour;

Laser coagulation, which is characterized by high efficiency and safety. The only drawback is a fairly high price for session of therapy. In the course of this procedure, a high-intensity laser affects a damaged mucous membrane. The operation is characterized by minimal injury to tissues, high accuracy and antibacterial action of a laser that reduces the risk of infections;

Removing the ridges and spikes of the nasal partition using surgical instruments.

In recent years, the most popular method of stopping epistaxis are manipulations produced on paranazine (maxillary, lattice) sinuses. In the process of this procedure, the damaged vessel is suspended. In some cases, it may be necessary to operate the mechanical destruction of the cells of the lattice sinus. Then the tamponade of the nasal cavity is performed.

In particularly severe cases, the testimony of the doctor is a dressing of trunk vessels, such as the outer sleepy and inner jaw artery. Such an operation is carried out in cases where other methods of therapy were ineffective. It most often does not cause complications and effectively stops bleeding.

With severe nasal bleeding caused by damage to the inner carotid artery, the angiography and embolization of the bleeding vessel located inside the skull are performed. This is a very promising method of therapy of particularly severe pathologies. Such an operation provides the ability to accurately block the damaged vessel portion from which bleeding occurs. The procedure is quite complex in execution and is impossible without expensive special equipment and experience in the surgeon. Unfortunately, this complex operation can sometimes lead to paralysis and bleeding large areas of the brain.

The current high-tech methods of microdoscopic and endoscopic surgery are characterized by unjustified complexity and are not always effective. At the same time, they can also lead to various complications.

In the event of nasal bleeding, a person must clearly determine what he can cope with independently or with the help of loved ones, and what requires the immediate intervention of the doctor.

When bleeding from the nose, you must perform the following actions:

Soothe the victim. For this, he must slowly breathe deeply. Such a step removes emotional excitement and prevents the healing of heartbeat and increase blood pressure, which only enhance blood loss;

Squirt Patient in a comfortable pose And lift his head, without throwing it back. The head should be slightly tilted forward. When the head is trapped, the blood flows on the nasopharynx, it may cause vomiting and entering blood clots in the respiratory tract leading to the disorder of the respiratory function. The patient's nose is substituted with a container for collecting flowing blood, which allow to accurately set the volume of blood loss;

Conduct events to stop bleeding. For this, the wings of the nose are pressed against the shapper with the fingers. Also, the patient can carefully free the nasal cavity from the blood clots accumulated in it. In purified nose, droplets from a cold (Galazoline, Nazivin, Sanorin, Tizin). They have a vasoconstrictor effect. In each nostril, they bury 5-6 drops of the drug. After that, there are 10 drops of 3% hydrogen peroxide. A very effective method of stopping bleeding from the nose is the irrigation of its cavity with cold 5% aminocaproic acid. Also, for this purpose, these preparations such as thromboplastin or thrombin can be used. The above procedures are comprehensively: the vessels are mechanically squeezed, the blood accumulated fasterly coats and dries, creating a peculiar tube, the nasal drops are narrowed by blood vessels, hydrogen peroxide and other drugs accelerate the blood formation process, stopping blood;

Attach a cold compress to the nose. It can be an ice bubble wrapped in a cloth or a cold towel. Every 15 minutes the compress is cleaned for a few minutes. Due to the effects of cold, blood vessels are narrowed, which quickly reduces the intensity of bleeding. Immersion of hands in cold water, and the feet in warmth also contributes to a faster blood stop;

Enter cotton swab in the nostrilsMixed in a solution of thoroughbuilding preparations (3% hydrogen peroxide, 5% aminocaproic acid). At the same time, the wings of the nose should be pressed to the partition for 5-15 minutes. During the removal of the tampon, it should be extremely neat to not damage the vessels again and move the resulting crust;

Give a patient to drink salted water (1 h. Spoon / 200 ml).

Sometimes first aid measures may not be enough. Immediately consult a doctor in the case of:

Injury to the nose and skull;

Incessant bleeding for a long time;

Too abundant blood loss (up to 200 or more milliliters);

Presence of infectious diseases;

Sharp deterioration of well-being, general weakness, pallor of skin cover, dizziness, loss of consciousness.

As the prevention of epistaxis, you can recommend:

Strengthening the walls of vessels by regular reception of vitamin C or ascorutin;

Maintaining normal blood pressure;

Training of blood vessels with a contrasting soul, bath, hardening by pouring;

Increase blood coagulation by taking vitamin K and calcium;

Ensuring the moisture of the nasal mucosa using ointments or oils;

Rejection of tobacco and alcohol;

Timely therapy of chronic kidney diseases, liver, vascular system;

Moderate physical exertion;

A healthy diet, which includes protein products such as cottage cheese, liver, chicken, turkey.

Since nasal bleeding is not only small local pathology, but also a sign of various diseases dangerous to human health, with frequent recurrences or abundant blood discharges, it is necessary to undergo a comprehensive examination to establish an accurate diagnosis and carrying out appropriate therapy.

About the doctor: From 2010 to 2016 The practitioner of the therapeutic hospital of the central health part number 2, the city of Elektrostal. Since 2016, it has been working in the diagnostic center number 3.

Among patients contacting the ENT-doctor 5-10% are persons complaining of spontaneous bleeding from the nose, 20% are hospitalized by emergency testimony, most often after injury.

Nasal bleeding after mechanical impact does not cause questions, since the reason is obvious, but usually anxiety causes often repeated blood releases without visible causes, both short-term and long-term, as abundant, tick and scanty, in children and adults.

Blood from the nose can go due to disruption of the integrity of the walls of the nose vessels or blood coagulation disorders. In 70-90% of cases, this comes from the vessels of the front sections of the nose, from the rear departments of bleeding is most difficult to stop and it is very dangerous for health, because larger vessels are damaged and its intensity is higher.

In most cases, this occurs due to disruption of the mucous membrane in the Kisselbach zone in the front of the nasal septum (a penny coin size). Here, the mucule is thin, loose and saturated with vessels, just in this vascular plexus zone even lighter damage leads to blood release.

The causes of frequent bleeding from the nose can be infectious diseases (tuberculosis, syphilis, etc.), liver disease, kidneys, rheumatism, manifestation of cardiovascular diseases. Blood can be isolated by rods, drops from nostrils or drain along the rear wall of the pharynx, accompanied by a decrease in pressure, weakness,.

Sometimes bleeding from the nose can be confused with bleeding from the trachea, lungs, nasopharynses, bronchi, stomach, esophagus. With the nasal blood of the usual species, clean.

Why is blood from the nose: external factors

The external reasons provoking the development of spontaneous bleeding in healthy people may be as follows:

Dry air - frequent nasal bleeding in children can be with excessive dryness indoors, especially during the heating season. This leads to a drying of the nasal mucosa, as if gluing it with small vessels, while the vessels become more brittle and losing their elasticity.

Overheating organism - One of the natural causes of a healthy person is. Such bleeding from the overheating of the body is accompanied by weakness, a fainted state, dizziness, noise in the ears.

Atmospheric or barometric pressure drops - They arise with a sharp descent to depth (when swimming at a depth, in divers), when lifting to a large height (pilots, climbers).

Professional intoxication or poisoning - Inhalation in everyday life or production of toxic vapors, aerosols, gases. The impact of radiation, electrical, chemical, thermal mucosa burns. For example, blood vessels and hematopoietic organs are affected during chronic poisoning, the permeability of the vessels walls is disturbed, causing bleeding from the nose, gums, etc. during phosphoric poisoning, acute hepatitis can develop in combination with hemorrhagic diathesis.

Strong cough and sneezing - At the same time, the pressure in the nose vessels sharply increases, leading to their damage.

Receive some medicines - antihistamine preparations (see), corticosteroids, nasal vesseloring sprays, drugs that dilute blood - aspirin, NSAIDs, heparin.

Local causes of nasal bleeding

Injuries

This is the most common cause both after automotive accidents and after production or household bruises - drop, blows leading to fractures of cartilage tissue. Such bleeding is usually combined with a pronounced swelling of the damaged region and the pain of surrounding tissues, with a fracture of cartilage tissue or facial bones, the deformation is visually noticeable.
In addition, injury to the nasal mucosa occurs during operations, treatment-diagnostic manipulations - puncture of the sinuses of the nose, sensing, catheterization of the nasal sinuses.

ENT disease

When the development of local pathological conditions, when the nasal mucosa is full, the nasal mucosa - with, sinusites, sinusitis (see). Chronic rhinitis, including the causes of bleeding, especially against the background of uncontrolled use of vasoconstrictor droplets into the nose or hormonal drugs that contribute to the thinning of the nasal mucosa and the development of its atrophy.

Dystrophic changes in the mucous membrane of the nose, veins development anomalies, curvature of the nasal partition

As indicated above against the background of the treatment of chronic allergic rhinitis, dystrophic processes in the mucous membrane occur during atrophic rhythm, contributing to the occurrence of nosebleed bleeding. The reasons are also anomalies for the development of veins and arteries (local expansions), a significant or superficial location of the vessels of the mucous membrane.

Tumors, adenoids, nose polyps

Frequent blood discharge from the nose can be the only sign of an emerging malignant or benign neoplasm in nasal passages - tumors, nose polyps (see), specific granuloma, adenoids (see), angioma.

General reasons for the appearance of blood from the nose

An increase in vessel fragments may occur in the following diseases and conditions:

Changing the wall of the vessels

Vasculitis (inflammation of the inner shell of vessels) - at the same time, bleeding is rarely abundant, sometimes accompanied by hemorrhage into the internal organs, muscles, joints and are always accompanied by rash. Read more.
Atherosclerosis of the vessels (see) may be accompanied by the advent of blood from the nose, this disease is threatened by the development of stroke and infarction.
Infectious diseases - chickenpox, measles, flu, tuberculosis (with the tuberculosis of the nasal cavity can be simply periodic blood peel in the nose), meningococcal meningitis lead to pathological changes in the vessel walls.
Hypovitaminosis is a deficiency of vitamin C, K, as well as calcium.

Change of hormonal background

With vibrations of the hormonal background - this is a teenage age, in women - during pregnancy, during the premanopause period.

Enhance arterial pressure

A sharp increase in blood pressure may occur as a result of physical and emotional overloads, against the background of the diseases of the cardiovascular system and not only, while the pressure of the pressure occurs the walls of the capillaries (small vessels) in the nose:

Hypertonic disease
Atherosclerosis
Heart defects accompanied by increased blood pressure
Aortic Stenosis, Mitral Stenosis
Chronic pyelonephritis and glomerulonephritis
Pneumosclerosis and lung emphysema
Tumors of adrenal glands
Overload - emotional and physical

Blood Diseases

Blood coagulation disorders is one of the symptoms of a group of acquired or hereditary pathological conditions and diseases accompanied not only to nasal, but also other bleeding.
Aplastic anemia or leukemia.
When blood often comes from the nose, the cause may be in the body (the so-called thrombocytopenic purple).

Other reasons

frequent Tamponade of the nasal cavity, contributing to the emergence of atrophy of mucosa and bleeding
kidney disease
osler's disease
agranulocytosis
emphysema lungs
and nervous disorders

Symptoms, signs of front and rear bleeding

Click to enlarge

Symptoms of nasal bleeding In addition to the very fact of blood expiration, symptoms of the underlying disease and signs of acute blood loss are added:

noise in ears
dizziness
tahcardia (heartbeat), shortness of breath
reduced arterial pressure
itching in the nose, ticking
headache
total weakness
skin pallor (insignificant)

With low bleeding, the symptoms of blood loss are usually not manifested. The expiration of blood can be both outside and inside. When blood hits on the rear wall of the rotogling, it does not go out, it can be found in pharyngoscopy. With severe blood loss, hemorrhagic shock can develop - a threaded pulse, a sharp drop in pressure, tachycardia.

When the front - source in 90% of cases is the Kiselbach zone, this is an extensive network of small blood vessels, which are covered with a sufficiently thin mucous membrane, almost without a submembrance layer. With such bleeding, it is usually not a strong bloodsture, it stops independently and does not threaten human life.
With the rear - large vessels are damaged, which are in deep deposits of the nasal cavity, it is dangerous for the patient and almost never stops independently.

To determine what bleeding - the front or rear, the doctor is examined by the patient, front rosicopy and pharyngoscopy are performed.

With gastric and pulmonary bleeding, blood can pushes into the nasal cavity and imitate the nose - this will see the doctor when examining the patient.
With a pulmonary - blood is foaming and brightly alley, with a dark red, the gastric is very dark, it looks like a coffee thickness.
With intense bowed bleeding, which flows over the rear wall, vomiting can occur with dark blood.

To find out what the main reason for bleeding from the nose is required, a general examination is required and the clarification of the symptoms of the underlying disease. To evaluate blood loss, you must pass a coagulogram and a general blood test.

First aid for nasal bleeding

Give an adult or child a half-row position, it is best to plant a person and tilt your head forward.
Attach cold to the nose for 10 minutes.
You can kill vasoconstrictor drops (Galazoline, naphtizin, nasivin, etc.), with their absence of hydrogen peroxide 3%, clamp the nostrils with your fingers.
If it does not help, then apply drops (or a weak solution of hydrogen peroxide) to a cotton swab (ball) and enter it in the nostril, pressed to the nasal partition.
If the blood from the nose flows from the right nostrils - lift the right hand up, with the left, press the nostril, if from both, then the patient raises both hands upwards, and the help providing help, presses both nostrils.
If these events do not help after 15-20 minutes, then the "ambulance" should be called.

After the bleeding stops, it is impossible to pull the tampon sharply, because it is possible to damage the thrombus and blood will go from the nose. It will be right before removing a tampon, moisten its hydrogen peroxide and only then remove.

Even after a lump-sum episode, especially in a child, it should be referred to as a doctor to clarify the possible cause and prevention of recurrence. To prevent drying, accelerate healing and reduce the risk of repeated bleeding, you can 2 p / day to lubricate the nose mucosa with vaseline (ointment of neomycine, bacitracycling), if in the apartment of dry air (heating season), the child can be buried in the nose with sea water - Aquamaris, Salin.

If it is not independently able to stop the blood, doctors can anemic of the mucous membrane with the ephedrine solution or adrenaline. If, after the front tamponade, the bleeding does not stop, then the rear tamponad is carried out. But usually the front tamponade helps well with the rear bleeding from the nose.

With often recurring blood release from the nose or with ineffectiveness, the tamponade is carried out surgical treatment. With frequent front bleeding, endoscopic cryodestruction, coagulation (ignition), and maybe the introduction of sclerosing drugs, etc.

When bleeding is impossible

Do not throw the head back and take a lying position - it enhances bleeding, blood can fall in the esophagus or respiratory tract. If she gets into the stomach - it will cause nausea and vomiting if there are in the breathing tracks.
It is impossible to high - it will shift the formed clutch, which can increase bleeding
If the foreign body is hit, it is impossible to extract it yourself.

When should I urgently ask for medical care?

In the cases listed below, it is impossible to waste time and wait for a spontaneous stop of bleeding, and it should be immediately called "ambulance":

Medical Help

Adults and children with severe bleeding and essential blood loss are hospitalized in the hospital in the ENT branch. If at home managed to stop it quickly, then the child should be shown to the doctor to the otolaryngologist and the adult also consult a doctor. With frequent bleeding from the nose in children and adults, when an explicit reason cannot be detected, a survey in a hematologist, an endocrinologist, neurologist should be examined.

Most often, blood flows from the Kisselbach zone to prevent new cases this place is migrated. The ENT doctor can take the following:

remove polyps, foreign body
rear or front tamponade, impregnated with 1% meacherl solution, epsilon-aminocaproic acid, canned amnion
introduce a tampon with a wagotyl or trichloroacetic acid for vessel migrating
coagulation by one of the modern methods: electric current, laser, ultrasound, silver nitrate, liquid nitrogen, chromium acid or endoscopic cryodestruction
it is possible to introduce an oil solution of vitamin A, sclerosing drugs
use hemostatic sponge
with strong blood loss, the use of fresh frozen plasma, transfusion of donor blood, intravenous administration of hemodesa, reopolylucine and aminocaproic acid
if the listed methods did not have an effect possible, surgery - embolization of large vessels (gleaming) in the problem area of \u200b\u200bthe nasal cavity
purpose of drugs that increase blood coagulation - vitamin C, calcium chloride, calcium gluconate, vikasol.

After nasal bleeding, it is not desirable to use hot dishes and drinks, you can not play sports for several days, because it contributes to the tide of blood to the head and can provoke repeated.

Prevention

according to the testimony of the reception of ascorutin to strengthen the walls of the vessels
moisturizing air in the heating season
full nutrition rich in natural vitamins and minerals
prevention injury.

Nasal bleeding (Medical term - Epistaxis, from Latin epistaxis) Specialists are not counted to the category of independent diseases. The root cause of nasal bleeding, as a rule, is the main disease, traumatic or allergic damage to the nose and its sinuses. Sometimes, for example, after severe physical exertion or strong overwork, nasal bleeding can be observed in a practically healthy person. In such a case, medical care for nasal bleeding is not required, because In a short time, the expiration of blood from the nasal passages is terminated independently.

Also, the discharge of non-hazardous states includes nasal bleeding, the reasons for which they lure in a sufficiently long stay in the frost or under dry, hot climate. Finding in such conditions leads to excessive dehydration and drying the mucous membrane of the nasal passages and as a result, it becomes the cause of small blood vessels.

Causes of nasal bleeding

The natural causes of nasal bleeding in an adult healthy person can be in unnecessary overheating of the body (the impact of solar or thermal impact). Nasal bleeding, resulting from overheating, is usually combined with dizziness, severe weakness, ears noise and a fainted state.

Nasal bleeding, the causes of which are traumatic character (blows, bruises, falls, etc.) are combined with a pronounced edema of the injured region and a sharp painfulness of nearby fabrics. If there is a fracture of facial bones or cartilage tissues, the deformation is visually noticeable.

The reasons for nasal bleeding, consisting in inflammatory processes in the nasal passages and surrounding sinuses (sinusitis, rhinitis, frontitis, sinusitis, etc.) are usually accompanied by mucous blood discharges with clots from nasal strokes, sometimes increased body temperature.

If nasal bleeding occurred in a person suffering from chronic hypertensive disease, then most often this symptom indicates a hypertonic crisis - a sharp increase in blood pressure, as a result of which the walls of the smallest blood vessels occur in the nose.

The causes of nasal bleeding can be the reception of some drugs, in particular, nasal sprays, drugs against allergies (antihistamines), corticosteroids, drugs against blood coagulation (aspirin, heparin, etc.).

In addition to the above reasons, nasal bleeding, arising quite often may indicate a reduced level of platelet production in the body (so-called thrombocytopenic purpura), as well as the possible presence of such formidable diseases as aplastic anemia or leukemia.

Frequent nasal bleeding can be the only sign of a starting benign or malignant neoplasm in the nose passage.

Nose bleeding in children

Features of the development of the respiratory system at an early age, determine the fact that nasal bleeding in children are not always caused by any pathological states. Most often, nasal bleeding in children is caused by damage to the mucous membrane of the nasal passages by mechanical method - fingers, introducing small foreign objects into the nose, traumatic damage to the nose during the fall, injury, etc.

If a child is distinguished in a child during bleeding from the nose, a mucus with dense bloody clots are distinguished, then most likely the inflammatory process in the nasal cavity flows (rhinitis, sinusitis, etc.) and appropriate treatment is required.

Long nasal bleeding in children arising constantly and combined with the occurrence of hematomas and bruises may indicate a violation of blood clotting processes or hemophilia disease.

Nose bleeding in pregnant women

Nasal bleeding during pregnancy is a fairly common phenomenon. This fact is explained by the fact that in the body of a pregnant woman often there is a significant lack of vitamin K - an indispensable participant in blood clotting processes. The lack of vitamin K is the cause of not only frequent nose bleeding, but also increased bleeding gums, as well as the emergence of numerous bruises in women during pregnancy.

If the nasal bleeding in a pregnant woman is accompanied by a strong headache or dizziness, then a given situation is associated with an increase in blood pressure (which often happens during pregnancy) and then urgent appeal to the pregnancy of a gynecologist is necessary.

Treatment of nasal bleeding

The provision of medical care and the treatment of nasal bleeding in a medical institution is required in the following complicated cases:

abundant nose bleeding in children with suspicion of a foreign bodies in the nasal passages;
nasal bleeding occurred as a result of injury and combined with swelling and deformation changes in the nose area;
nasal bleeding occurred in a patient with a diagnosis of "chronic hypertension" on the background of the jump of blood pressure;
frequent and abundant nose bleeding, combined with the formation of numerous bruises and hematomas, bleeding of gums and other symptoms of violations of blood coagulation function;
the nasal bleeding of any etiology, which does not stop when making independent measures at its stop over a time exceeding 30 minutes.

In the hospital's conditions, the following manipulations are used to eliminate the incessant nosebleed bleeding:

Tamponade of nasal passages, in which gauze (lubricated by special hemostatic paste or vaseline) tampons in the nasal cavity are introduced. Tamponade can be produced by both the oral cavity (rear) and the side of the nasal passages (front);
The operational stop of nasal bleeding is shown in cases where the remaining trial measures were ineffective.

One-time nose bleeding treatment do not require. Special attention should be paid to the state of their health, if the bleeding from the nose is repeated quite often (without any visible cause, explaining it). In this case, the optimal option will be the appeal to the doctor to clarify the exact causes of nasal bleeding.

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Epistaxis, or bleeding from the nose, It may be a symptom of a number of nose diseases and other organs, and in addition, in some cases, healthy people are celebrated.

The main causes of the occurrence of bleeding from the nose can be:
injuries
nose diseases and spicy sinuses (sinusitis, rhinitis),
receiving a number of drugs,
blood diseases and so on.

With pronounced bleeding from the nose, it is impossible to stop which is not possible, it is necessary to urgently consult a doctor, which will determine the cause of the epistaxis, and determine the course of treatment.

Causes of Epistaxis in adults

Bleeding from the nose is not in all cases indicate an existing disease and sometimes can appear in people without health problems. Bleeding from a nose that occurs in a healthy person is usually not abundant depends on the previous emotional and physical exertion and can be stopped without outside interference.

Often the reason for bleeding from the nose in a healthy person is inhalation of it for a long time of frosty or dry air, which causes the drying of the mucous membrane of the nose and the break of small vessels. Usually, in this case, nasal bleeding is not distinguished by abundance and stops without difficulty.

"Sunny blow" (overheating in the Sun) can also cause the appearance of bleeding from the nose in a healthy person. In this situation, the satellite of Epistaxis is the pain in the head, weakness, noise in the ears and even faint.

With the appearance of nasal bleeding as a result of injury to the nose (blow, drop), there is likely damage to the nasal structures (separation sinuses, cartilage and so on.). Usually, the epistaxis, which has occurred as a result of injury, is accompanied by edema and obvious pain in the field of nose and tissues that surround it. In case the result of injury was the fracture of the front skull bones, the deformation of the nose or the entire face becomes noticeable.

If, in case of non-bleeding from the nose, the mucous membralls from the nose appear on the type of blood clot, the inflammation of the nasal mucosa appears, the so-called. rhinitis. Blood clots, highlighted with ritin, appear as a result of injury to small nasal mucosa due to inflammation.

When the epistaxis occurs on the background of pain in the head, runny nose and is accompanied by an increase in body temperature, probable cause can be inflammation of the incomplete sinuses - sinusitis (frontitis, sinusitis, etc.).

When nasal bleeding in a patient with hypertensive disease, a probable reason is a significant increase in blood pressure - hypertensive crisis. In this case, the epistaxis occurs as a result of the rupture of small vessels of the nasal mucosa due to increased pressure.

The appearance of nasal bleeding can be associated with irritation of the mucous membrane of the nose against the background of using a number of nasal sprays: Baconase, Nazisoneks and other drugs containing corticosteroids or anti-allergic (antihistamines) means. The formation of epistaxis is probably in humans for a long time receiving drugs that prevent blood coagulation: Warfarin, Heparin, Aspirin etc.

Often emerging bleeding from the nose, in particular, combined with uterine bleeding, a tendency to the appearance of bruises, increased bleeding gums, are characteristic of such blood diseases, as an aplastic (when the bone marrow ceases to generate blood cells), leukemia (malignant blood illness), thrombocytopenic purpura (strong decrease in platelet numbers), etc.

Epistaxis is also one of the signs of nasal tumors (both malignant and benign). The main symptoms of nasal tumors are as follows:
painful ulcers or swelling in the nose,
blood discharge from the nose (transparent in appearance),
changing the shape of the nose,
pain in the head and so on.

Causes of Epistaxis in children

Bleeding from the nose in childhood is also not in all cases indicate an existing disease and may be associated with mechanical irritation (for example, fingers) of the nasal mucosa, nasal injury, ingredients in the nose (small particles of toys, peas, etc. ).

If the child appears mucous discharge from the nose, in which blood clots are present, this usually speaks about the existing cold (ritin).
Stubborn, often emerging nose bleeding in children who are combined with a tendency to form bruises, may indicate hemophilia or a number of other diseases that are associated with blood clotting disorders.

Causes of Epistaxis in pregnant women

The main causes of the appearance of bleeding from the nose in pregnant women are:
inhalation of frosty or dry air for a long time (in winter during walks),
the shortage in the body of calcium or vitamin K, which occurs during pregnancy and may become the cause of epistaxis, as well as increased bleeding gums, etc.
nasal bleeding, accompanied by pronounced pain in the head, may arise due to increased blood pressure. In this case, medical care is required. It will be measured with pressure and determine the likely cause of bleeding.

First aid when bleeding from the nose in children and adults

In the event of bleeding from the nose, it is recommended to follow the following rules:
1. The patient should be planted and tilt his head forward. Strictly prohibited to throw the patient To avoid swallowing blood and vomiting or blood penetration into the respiratory tract!
2. It is necessary to provide a patient with epistaxis good fresh air access (swinging out the window, unzip the patient a shirt collar).
3. Attach a bag of ice to the man's nose. If the stop of bleeding did not happen, with the help of a finger, press the nostril to the nasal partition approximately 5-10 minutes. Due to the squeezing of the vessels of the nasal mucosa in most cases, bleeding occurs.
4. If the nose injury was the cause of nose bleeding, while it is accompanied by a change and swelling of the nose circuit or the whole person, put the nose-moistened handkerchief in cold water or a bag with ice and urgently consult a doctor.
5. If the measures taken did not help stop bleeding from the nose, you can use any vasoconstrictor drug from a cold (for example, Naphtizin, Nafazolin, Sanorin And so on.). To do this, make a tampon from a small piece of gauze or bandage, about about 10-15 See this tampon must be mixed in the medicine and introduce into the nasal cavity.
6. When nasal bleeding is the result of the previous runny nose, it is necessary to lubricate a cotton tampon with a vaseline and introduce into the nasal cavity. As a result of the operation of the Vaseline, the crust formed in the nose will soften, and the bleeding will stop.
7. When the bleeding from the nose is manifested against the background of overheating, it is necessary to immediately remove the patient into a well-ventilated place where the sun's rays do not penetrate. On the area of \u200b\u200bthe nose it is necessary to apply fabric moistened in cold water.

In which situations need to urgently contact the doctor?

In the following situations, it is necessary to urgently consult with a specialist:
when bleeding from the nose, which arose as a result of injury, combined with deformation and swelling of nasal contours;
with abundant bleeding from the nose, which appeared against the background of increased blood pressure or due to the long reception of the medicines listed above;
when bleeding from the nose, which appeared in the child due to penetration of a foreign body, should be referred to a specialist - Laura. It is forbidden to try to pull the foreign body yourself!
when bleeding from the nose, not stopping more 30 minutes, and if the measures listed above do not bring the result;
with frequently emerging nasal bleeding, not stopping for a long time, accompanied by a tendency to form bruises and elevated bleeding gums and so on.

Treatment of nose bleeding

In a situation where bleeding from the nose wears a persistent character, medical care includes:
1. Tamponade of the nasal cavity - The method of stopping bleeding from the nose, assuming the introduction into the nasal cavity of the gauze, pre-treated with a vaseline or special paste, which helps clot blood. There are two methods for entering a tampon: anterior tamponade (the introduction of a tampon on the part of the nostrils) and the rear tamponade (from the side of the rotogling).
2. Use surgical methods Stopping bleeding from the nose is assumed in situations where the remaining methods do not give effect, and implies blockage or dressing of arteries supplying nose with blood, and a number of measures.

Minor, single nasal bleeding do not imply special treatment. With frequently repetitive nasal bleeding, it is necessary to refer to a specialist who will conduct an inspection, prescribe additional analyzes and determine the cause of bleeding from the nose.

With nasal bleeding arising against the background of a sinusitis or rhinitis (runny nose), special treatment is required. In such a situation there will be sufficient measure conducting therapy of the underlying disease.

When bleeding from the nose appeared against the background of taking drugs that depress blood coagulation ( warfarin, Heparin And so on.), It should be consistent with the doctor to adjust the dosage of drugs or the purpose of calcium and vitamins.

Epistaxis, or nasal bleeding, is a fairly common phenomenon, occurring in both adults and in children as a result of various diseases or other reasons. Visually, this is manifested in the form of varying degrees of the intensity of blood flow from the nostrils.

Nasal bleeding are divided into front and rear. The separation is based on the physiological features of the blood supply to the nose.

What are nasal bleeding

In most cases, the source of bleeding is the plexus of Kisselbach. Such bleeding is expelled, stops independently after 3-5-7 minutes.

The source of the most common front bleeding (in 90-95% of cases) is Kiselbachu's plexus - a thick submembrance cavernous venous network with a mass of small capillaries and arterioles supplying blood to the front of the nose cartilage. Epistaxis from this area, as a rule, is not dangerous due to the small volume of blood loss. Blood flows out with a thin trickle, or drops. With normal coatability, bleeding is independently stopped within a few minutes.

In 5-10% of the cases of rear-type bleeding, the blood flows from the branches of the large arteries of the rear or middle departments of the nose. Bleedings from these arteries are abundant, may have serious health effects and even in rare cases to lead to the patient's death. The blood of the bright-scarlet color follows the continuous jet. Such bleeding does not stop independently. Another manifestation of the rear epistaxis is the appearance of blood in the mouth and the bloody vomiting, which occurs from the swallowing of blood flowing from the nose through the throat into the oral cavity.

In some severe cases, bleeding from the eye or a lacrimal point can be observed, while the blood rises from the nose up the weasting canal.

Depending on the volume of blood flowing, several degrees of blood loss are distinguished:

Minor blood loss at which it is lost from several drops to a few milliliters of blood. Such bleeding is not hazardous for health and does not lead to any consequences. The only negative point may be fright, hysterics or fainting in young children.
Easy degree of blood loss, the volume of blood at which does not exceed 700 ml in an adult, it is not more than 12% of the total number of circulating blood. Such blood loss causes light weakness, dizziness, rapid pulse and flickering flies in front of the eyes. It is possible to pace the visible mucous membranes and skin.
The average degree is characterized by blood loss from 1000 to 1400 ml in an adult, which is up to 20% of the total circulating blood. It is accompanied by more pronounced symptoms in comparison with a slight degree: weakness, dizziness, headache, thirst, shortness of breath.
Severe degree with massive bleeding. The volume of blood loss exceeds 20% of the entire circulating blood in the body. Massive blood loss leads to hemorrhagic shock expressing in a sharp fall of blood pressure, inhibition, various disorders of consciousness up to its loss, insufficient blood circulation in the internal organs. Large danger represents sudden short-term, but massive bleeding, leading to a large blood loss.

Causes of nasal bleeding

Why is blood from the nose? Consider the reasons. Factors causing nasal bleeding are divided into local (local) and general (system).

Local factors:

Various .
Mechanical damage to the internal structures to which the mucous membrane relates. The violation of its integrity can occur with the inactive removal of dried crusts, from intensive scratching in the nose with a finger, coarse repeated blowing off, etc. Small children love to shove into mouth and nose different foreign objects, thereby causing injury to the mucous membrane.
Barotrauma with a sharp drop of barometric pressure, characteristic of divers, pilots, climbers.
Full-line mucosa, its thinning or effect on it with various drugs with inflammatory processes in the nose, for example, with influenza, or chronic sinusitis. Special risk when used to treat nasal steroid spray.
Inhalation through the nucleation nuclear agent, mostly cocaine.
Anatomical nose deformations. As an example, or telegangectasia, caused by Randu-Osler's disease.
and. Oncological attributes include NazoFaringEal carcinoma, to benign - angioma or.
Long inhalation of cold winter air. In this case, the relative humidity of the air itself plays the role.
A thermal or sunshine from being under the scorching sun in hot weather.
Epistaxis as the consequence of surgical intervention in the nose zone.
Possible drainage of the mucous when using an oxygen catheter.

Systemic factors of nasal crust:

Arterial hypertension.
Vascular disease.
Congenital vascular pathology.
Blood diseases (leukemia, hemoblastosis, anemia, etc.).
Avitaminosis, mainly lack of vitamin C and K.
The use of alcoholic beverages that contribute to the expansion of vessels, including in the nose.
Heart diseases accompanied by heart failure.
Connective tissue diseases.
Side effects from taking NSAIDs (non-steroidal anti-inflammatory drugs).
Diseases accompanied by a blood coagulation disorder such as hemophilia.
Hemorrhagic diathesis.
Heavy kidney pathology.
Physical overvoltage.
Heavy infectious diseases, including HIV infection, AIDS.
Hormonal restructuring of the organism.

First prefigible help when bleeding from the nose

With nasal bleeding, you should not throw the head back! On the contrary, it is necessary to slightly tip the head and torso ahead and fingers press the wings of the nose to the bridge. It is desirable to put a cold on the bridge.

A person who has blood from the nose can be helped to appeal to the doctor. To do this, it is necessary to produce a number of manipulations alternately:

First of all, put a person and slightly lower your head to ensure good blood outflow. If the patient is difficult to sit independently, it is better to put it, but lift the head end of the couch, and turn the head. Common folk measure as heading of the head, strictly prohibited. It will not stop blood, but only can lead to undesirable consequences in the form of penetrating it in the mouth, swallowing in the stomach, and in severe cases - enter the respiratory tract.
Provide the influx of fresh air (unbutton the shirt, open the window).
On the bridge to put a bag with ice. If the bleeding was not stopped after a short time, then you need to press the nostril, from which blood flows more to the nasal partition for 5 or 10 minutes. To be frozen. If blood gets into the oral cavity you need to spit it.
If the above measures did not give the result, you can try to make Torundu or Tampon from sterile wool, moistened by its 3% hydrogen peroxide or, for example, sanorin, naphtizin, galazolin, tizin. Such Turunda introduce into the nasal stroke and leave before stopping bleeding.
When the epistaxis is and the crusts formed after it, then the tampon is desirable to lubricate the petroleum. Mitigation of dry mucosa will help stop the bleeding.
If nasal bleeding is caused by a sun blow, then the person needs to be transferred to a cool well-ventilated place and put a cool fabric on the forehead and face, and the ice is on the bridge.

With massive bleeding, the consequence of the nasal injury with the distortion of its anatomical structure, or in the case when it does not work independently to stop the blood, you need to immediately contact the doctor, and to temporarily put a cold to remove the edema.

Nasal bleeding

After inspection, determining the degree and causes of bleeding, the doctor chooses a way to stop it and, if necessary, further treatment.

Specialized medical care consists of the following measures:

Tamponade of the nose is a way to stop nasal bleeding by introducing into its cavity of tampons impregnated with one of their hemostatic agents, for example, thromboplastin. A hemostatic sponge helps well, which includes thromboplastin and thrombin.

Depending on the situation, the doctor makes the front tamponade - on the part of the nostril, or the rear - from the pharynx.

Cutting bleeding vessels. There are many ways. The means of causthing serve some acids - dairy, trichloroacetic or chrome. Zinc salts, alum, tannin, a solution of nitric acid silver are also used.
Highly efficient modern methods of stopping nasal bleeding are ultrasound disintegration (the intentional destruction of the prevailing blood supply to hypertrophied nose shells with an ultrasonic waveguide), laser therapy (coagulation with a laser), exposure to liquid nitrogen (cold), electrocoagulation (electricity cavity).
With frequent bleeding, accompanied by a significant loss of blood, a surgical operation is shown in the dressing of large vessels and arteries, as well as in the trapping of the periosteum at the place of bleeding, leading to the launch of the vessels.

It is important to know that the nasal bleeding is not always harmless. Often it is a symptom of serious diseases. If it does not stop strong and for a long time, and even more often repeats, leading to a deterioration in the state, then it is mandatory to consult a doctor for a detailed examination in order to determine the causes of the epistaxis and choosing a method of qualified treatment.

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