Pediatric rhinorrhea is a common disease in pediatric otolaryngology, with a particularly high incidence in the spring and fall/winter seasons. Some children bleed occasionally a few times, while others bleed repeatedly many times and in large amounts, often causing panic among children and worry among parents.
Causes of nasal bleeding.
1, nasal inflammation: allergic rhinitis because the mucous membrane is highly edematous, rubbing the nose will cause the mucous membrane to rub against each other and bleed. Sinusitis secretions accumulate in the nasal cavity, nasal vestibule, causing itching, dryness and pain and other discomfort, because children do not blow their noses, but often dig their noses with their hands and cause nasal bleeding.
2, trauma: children are naturally active, falls and bruises often cause nasal bleeding, in addition, some children like to dig nose often lead to nasal vestibule erosion and mucosal erosion and oozing blood.
3.Fever: Fever often leads to dry microvascular rupture and bleeding of the nasal mucosa.
4, nasal foreign body: children often inadvertently stuff playthings, paper balls, fruit rinds, melons, etc. into the nasal cavity secondary to infection, causing mucosal erosion and bleeding.
5.Blood diseases: Children with leukemia, thrombocytopenia, hemophilia and aplastic anemia have nasal bleeding due to blood clotting disorders.
6.Rheumatic fever.
Examination methods for rhinorrhea.
1, anterior rhinoscopy: observe the state of nasal mucosa, the presence of pus in the middle nasal tract, which can discern whether there is allergic rhinitis or sinusitis; check whether there is foreign body residue in the nasal cavity; clarify the bleeding site.
2.Electronasopharyngoscopy: it can observe whether there are bleeding lesions, superfluous organisms and foreign bodies in the deep part of the nasal cavity.
3.Laboratory examination: blood routine, C-reactive protein, clotting time determination, to clarify the presence of systemic infectious diseases and exclude basic blood diseases.
Treatment of rhinorrhea.
1.Clear the clot in the nasal cavity and apply 1% ephedrine to contract the nasal mucosa and nasal blood vessels, which can effectively reduce and treat nasal bleeding.
2, finger pressure to stop bleeding: If the bleeding is small, let the patient sit down, use the thumb and forefinger to press the patient’s nose on both sides, press the nasal septum, and temporarily let the patient breathe through the mouth. At the same time, put a cold towel on the patient’s forehead, generally compress for about 5-10 minutes, the bleeding can be stopped.
3, compression and stuffing method: If the bleeding is large, or the upper method can not stop the bleeding, compression and stuffing can be used to stop the bleeding. Specific practice is: use skim cotton rolled into a strip as thick as the nostril, to fill the nasal cavity. Do not loosely fill the stuffing, because the stuffing is too loose to achieve the purpose of stopping the bleeding. Then continue to pinch the bilateral nasal wings for about 10 minutes, that can stop the bleeding.
4.If the bleeding still cannot be stopped, it is necessary to send to hospital for treatment.
5.Cause treatment: clarify the cause of nasal bleeding, treat the original cause, and stop nasal bleeding again. The most common causes of rhinorrhea in children are allergic rhinitis and sinusitis, which need regular treatment.
Prevention of rhinorrhea.
1, control strenuous activities, avoid nasal trauma: children’s nasal bleeding in addition to local inflammation of the nasal cavity, strenuous activities can also make the nasal mucosa vasodilatation, or lead to nasal itching. Children digging nasal cavity is also easy to cause nasal bleeding, in addition to avoid strenuous exercise, but also let children develop good habits, do not pick nostrils at will.
2, in the diet should pay attention to a light diet, eat less fried fatty food, eat more fresh fruits and vegetables, and pay attention to replenish water. You can take silver flower, chrysanthemum, maitake, etc. to prevent.
3, the prevention of acute infectious diseases of the respiratory tract: cold, tonsillitis, pneumonia or mumps and other infectious diseases, it is easy to lead to congestion and swelling of the nasal mucosa blood vessels, and even cause capillary rupture bleeding. Therefore, to prevent rhinorrhea, respiratory diseases should not be ignored.
4, clean the nasal cavity and moisten the nasal mucosa: it is recommended to use physiological marine water to clean and care for the nasal cavity. It is recommended to use nebulized quantitative micro-spray constant pressure type of canned physiological marine water to avoid incorrect nasal rinsing triggering otitis media. The use of physiological marine water can moisturize the nasal mucosa and prevent excessive dryness and bleeding of the nasal mucosa; it can physically remove the accumulated blood crust and pus nasal crust in the nasal cavity to prevent secondary damage caused by the above crust and improve nasal ventilation; reduce mucosal edema and remove the accumulated allergens and inflammatory mediators in the nasal cavity to reduce the occurrence of allergic reactions.