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2006, vol. 59, br. 9-10, str. 443-449
Epistaksa kod bolesnika sa hereditarnom hemoragijskom telangiektazijom
Klinički centar Vojvodine, Novi Sad

e-adresaljjovan@Eunet.yu
Ključne reči: epistaksa; hereditarna hemoragijska teleangiektazija + etiologija + terapija
Sažetak
Hereditarna hemoragijska teleangiektazija je nasledno vaskularno hemoragijsko oboljenje, u čijoj se osnovi nalazi genetski poremećaj angiogeneze. Oboleli imaju angiodisplastične promene na koži, sluznicama i visceralnim organima. Krvarenja se kod više od 90% obolelih manifestuju epistaksom. Tokom starenja bolesnika, teleangiektazije imaju tendenciju povećanja kako broja tako i veličine, pa epistakse postaju teže i češće. Kod aktuelnih krvarenja iz nosa, u zavisnosti od obilnosti treba primeniti pritisak, lokalne hemostiptike, laser, argon-plazma koagulaciju, fibrinski lepak. Kod izuzetno obilnih krvarenja treba primeniti balon za epistaksu sa ligaturom arterija i/ili embolizacijom. Tamponadu nosa i elektrokauterizaciju treba izbegavati. Kod recidivantnih krvarenja iz nosa topički se primenjuju: laser, argon-plazma koagulacija, kaustici, antifibrinolitici, fibrinski lepak, bleomicin i sklerozirajuća sredstva. Hormonalnu terapiju je najbolje primeniti kombinacijom estrogena i progesterona. Sistemska terapija antifibrinoliticima kao i septodermoplastika daju povoljne rezultate. Hirurško zatvaranje nosnih šupljina je jedina u literaturi opisana metoda definitivnog rešavanja problema teške refrakterne epistakse kod ovih bolesnika.
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O članku

jezik rada: srpski
vrsta rada: pregledni članak
DOI: 10.2298/MPNS0610443J
objavljen u SCIndeksu: 02.06.2007.

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