《鼻出血》ppt课件.pptVIP

鼻衄 hemorrhinia The peoples Hospital of Yunnan Province second Department of ENT chen juan 教学目标Teaching goal 重 点 鼻衄的治疗及护理诊断护理措施 Key point Treatment and nursing diagnosis and nursing measures of nasal bleeding 难 点 前鼻孔填塞和后鼻孔填塞的适应症 Difficult point Indications for anterior nostril and the nasal packing after packing 掌 握 鼻衄的概念、病因及健康指导 Master The concept, etiology and health guidance of nasal bleeding 概念Conception Hemorrhinia is one of the common symptoms of nasal disease, one of the symptoms is also certain systemic diseases or nasal lesions adjacent structure 鼻出血(hemorrhinia)又称鼻衄，是鼻腔疾病常见症状之一，也是某些全身性疾病或鼻腔邻近结构病变的症状之一。其出血量多少不一，轻者反复涕中带血，因反复出血，可导致贫血；重者可大量出血而休克，危及病人的生命。 病 因Cause of disease 1.局部原因：炎症、外伤、肿瘤等 Local reasons: :Inflammation, trauma, tumor etc 2.全身原因：高血压、糖尿病、血液系统疾病 Systemic causes ： Hypertension, diabetes, blood diseases 3.解剖因素：鼻中隔偏曲、血管畸形等 Anatomical reasons：Deviation of nasal septum, vascular malformations 出血部位Bleeding site 前鼻孔出血:青少年多见 anterior nares bleeding：Teenagers see more 后鼻孔出血：老年人多见 choanal hemorrhage: Old rare 中鼻道、嗅裂区出血：特发性出血引起多见bleeding occurs in smell crack area ,middle nasal meatus 鼻咽部出血：鼻咽癌、纤维血管瘤引起多见 nasopharyngeal hemorrhage 鼻中隔立特氏区 鼻中隔前下部有鼻腭动脉(颌内V-蝶腭V）、筛前动脉（眼动脉）、上唇动脉鼻中隔支（面动脉）及腭大动脉（颌内V-蝶腭V-腭降V）分支相互吻合，形成网状血管丛。 鼻中隔前下部粘膜甚薄，血管极易损伤，且由于这些血管与软骨关系紧密，破裂后不易收缩。 鼻中隔前下部极易因挖鼻而损伤，若鼻中隔有偏曲或距状突，这种情况更为常见。 鼻出血处理Treatment of nasal hemorrhage Treatment of a small amount of bleeding 1. Ice, squeeze the nose front 2. Local burning, freezing treatment 3. Anti infection treatment Treatment of massive hemorrhage 1.Vaseline sand packing 2. Sedation, anti shock, anti infection, hemostatic drug treatment Nasal packing :Using padding, nasal packing, compression hemostasia location, is the rupture of vascular thrombosis and reach the purpose of hemostasis 鼻腔填塞法（nasal packing）：此法是利用填塞物填塞鼻腔，压迫出血部位，使破裂的血管形成血栓而达到止血目的。 前鼻孔填塞法Anterior nasal packing 后鼻孔填塞法Posterior nasal packing 手术方法：后鼻孔填塞法（1）先用凡士林纱条做成与患者