What is the treatment of hypertensive epistaxis?

Hypertensive epistaxis is a common clinical emergency, which is characterized by sudden onset, fierceness, the large amount of bleeding, and prone to complications. There are many factors affecting nosebleeds. High blood pressure is a common systemic disease. Microvascular aneurysms are formed due to vasoconstriction in patients with hypertension, which leads to increased brittleness of blood vessel walls and more likely to cause bleeding. Nosebleeds in middle-aged and older people over 40 years of age are related to hypertension.

Generally, the nosebleeds caused by high blood pressure mostly occur in the early morning or after the activity. Because the bleeding site is in the back of the nose, coupled with high blood pressure, poor blood vessel elasticity and heavy bleeding, patients see more bleeding, and they will be nervous, so Higher blood pressure causes more bleeding.

Repeated nosebleeds are also a precursor to cerebral hemorrhage.

Patients with chronic hypertension have varying degrees of microaneurysms. Before the rise in blood pressure caused the cerebral vessel wall to rupture, a blood vessel in the nasal cavity had ruptured and bleeding occurred. Therefore, for the elderly with hypertension and arteriosclerosis, special attention should be paid to nosebleeds. Patients with hypertension have nosebleeds and should not be taken lightly. In severe cases, accidents such as syncope may occur, so they should go to the hospital for treatment in time.

Hypertensive nosebleeds often occur during intense exercise or mood swings, with severe bleeding and bright red color. There are often signs before bleeding, such as fever all over the body, and the feeling of blood rushing to the head and face, causing dizziness, headache, and subsequent bleeding. Strokes can often be avoided if found in time. The cause of nosebleeds is not only hypertension, but also many other diseases that can cause nosebleeds. Can be roughly divided into two categories of systemic factors and local factors. Among them, systemic factors include: in addition to hypertension, vascular sclerosis (more common in middle-aged and elderly people); blood system diseases such as hemophilia, thrombocytopenic purpura, leukemia, aplastic anemia; liver disease, coagulation dysfunction; Hyperfunction; fever; working at height; women’s premenstruation. Local factors include: nasal trauma, nasal benign diseases (such as nasal septum deflection, hemorrhagic and necrotic polyps), nasal tumors (such as hemangiomas, malignant tumors), and vasodilation of the front end of the nasal septum.

Once you experience nosebleeds, you should first be sedated. Blood pressure will increase during emotional stress, which can worsen nosebleeds. Mild nosebleeds can be handled at home. The specific method is to use local hemostasis: firstly, soak the cold water with ice towel and apply the forehead and nose, so that local blood vessels contract and stop bleeding, and at the same time pinch both sides of the nose with fingers for 10-15 minutes. If there is still more bleeding after loosening the fingers, cotton pads soaked with 1% ephedrine saline or 0.1% epinephrine can be used to insert the nasal cavity to stop bleeding. Or use cotton wool to dip squid bone powder or Yunnan Baiyao powder, Panax notoginseng powder, etc. into the bottom of the bleeding nasal cavity, press for 5 to 10 minutes, you can quickly stop bleeding.

The basic method of hypertension to prevent nosebleeds is usually to lower blood pressure and soften blood vessels. Eat foods and health products that soften blood vessels. Vegetables, fruits, etc. all contain vitamins (especially vitamin C). With normal blood pressure and softened blood vessels, bleeding naturally does not occur easily.


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