Diagnostic and treatment of nose bleeding in children with chronic hepatitis B

State of the problem: Nasal bleeding is one of the most common causes of patients seeking emergency otorhinolaryngological care, as well as the most common type of bleeding in medical practice. Frequent causes of nosebleeds are changes in the vascular wall, hemorrhagic diathesis, atherosclerosis, as well as diseases of the blood, kidneys, liver. Purpose of research: To study the clinical course and effectiveness of some methods of treatment of nosebleeds in chronic hepatitis B in children. Materials and methods: We observed 78 children aged 3 to 17 years. The method of examination included a detailed study of complaints and anamnesis of patients, endoscopic examination of the nasal cavity, radiography of the nose and paranasal sinuses. Patients were divided into 2 groups. The first group consisted of 30 patients in whom treatment was carried out by the proposed method (after detachment of the mucous membranes into the nasal passages of the patient, a standard hemostatic sponge swab soaked in solcoseryl Gel was introduced), the second group included 20 patients who received traditional treatment (effect on the bleeding area with vaseline, which was previously applied to the gauze swab). Results: Chronic hepatitis b In children retains its characteristic clinical signs, including subatrophy and dryness of the mucous membranes of the nose, nasal bleeding, adhesions of the nasal cavity, the hepatosplenomegaly and the violation of some biochemical parameters. Nosebleeds on the background of chronic hepatitis B occur with frequent relapses, which contribute to the severe course of chronic hepatitis B and can lead to an unfavorable outcome. Conclusion: Good clinical effect of selective sparing surgical technique: endoscopic submucosal detachment of the nasal septum in the region of the zone of Kisselbach, with subsequent tamponade hemostatic sponge impregnated with ointment “Solcoseryl”.

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