Pediatric rhinorrhea is a common disease in pediatric otolaryngology, with a particularly high incidence in the spring and fall/winter seasons. Some children bleed a few times occasionally, while others bleed repeatedly for many times and in large amounts, which often causes panic among children and worry among parents. The nasal mucosa of children is particularly thin, only 1/10 of that of adults, and children like to pick and rub their noses, so they are more likely to bleed than adults.
The causes of nasal bleeding in children must firstly exclude nasal bleeding caused by hematological and systemic diseases (such as high fever, uremia, long-term use of anticoagulant drugs, etc.); secondly, for children with recurrent nasal bleeding and heavy bleeding, nasal endoscopy should be performed to exclude bleeding tumors in the nasopharynx and nasal cavity; furthermore, long-term chronic rhinitis and sinusitis can also cause inflammation of the nasal mucosa, capillary dilation and mucosal The bleeding is caused by vesiculation.
The vast majority of pediatric bleeding sites are in the bilateral nasal septum in the Richter area, and on examination, mucosal erosion in the Richter area, capillary dilatation, exposure, sometimes pulsating bleeding spots, and broken ends of blood vessels are seen.
For nasal bleeding caused by hematologic and systemic diseases, it is usually difficult to control the bleeding at home, and it is necessary to stop the bleeding with a nasal cavity plug in the hospital. For nasal bleeding caused by hemorrhagic tumors in the nasopharynx and nasal cavity, surgical treatment is required. For most common causes of nasal bleeding, it is easier for parents to control the bleeding themselves.
First of all, do not panic, comfort the child and stabilize the emotion, because the more you cry and quarrel, the more bleeding. Secondly, you can fill a cotton ball in the nasal cavity on the bleeding side, or if you have ephedrine nasal drops at home, you can put nasal drops on the cotton ball and then fill it, and at the same time, pinch the child’s bilateral nasal flanks with your thumb and index finger, which can usually stop the bleeding in 4-5 minutes.
In autumn and winter when it is cold and dry, children should be encouraged to drink more water, eat more cool fruits and control the room temperature and humidity, too hot and too dry are prone to bleeding. Erythromycin eye ointment and petroleum jelly can be used daily in the nasal cavity for 1-2 weeks, the effect is also good. Dates, cinnamon, chocolate and other foods tend to cause nasal bleeding.
Children with rhinitis and sinusitis should be treated at the ear, nose and throat clinic, and the bleeding will improve when the inflammation is controlled and improved.
Finally, for children with frequently recurring nasal bleeding, which is not treated by the above methods, with mucosal erosion in the Lai area, dilated capillaries, revealed, sometimes visible pulsating bleeding points, and broken ends of blood vessels, they can go to the outpatient clinic for nasal endoscopic microwave coagulation to stop bleeding, which is completed in a few seconds, and one nasal cavity can be treated at one time.