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02-03-2011

Santé

Comprendre le saignement de nez

L'épistaxis, autrement dit le saignement de nez, est un épisode qui peut facilement impressionner. Un choc durant un entraînement sportif, un enfant qui met ses doigts dans le nez avec un peu trop de vigueur, un coup de tension ou une fatigue passagère… les raisons peuvent en être multiples. Rassurez-vous, dans 90% des cas cette hémorragie est bénigne. Alors que faire ? Attendre que ça passe ? Mettre la tête en arrière ? Explications.

L'épistaxis est surtout fréquente, voire banale durant l'enfance. Elle cesse de se manifester d'elle-même en principe, au moment de la puberté. Ses origines sont néanmoins multiples :

La tache vasculaire
Située dans la partie antérieure de la cloison nasale, cette zone fragile peut saigner facilement. Un simple doigt dans le nez peut déclencher un écoulement sanguin. Il n'est donc pas surprenant que les enfants soient les plus concernés…

Un traumatisme
Un mauvais coup, une fracture du nez, les suites d'une chirurgie du nez ou des sinus… ou la prise de drogue par voie nasale sont des facteurs favorisants de l'épistaxis ;

Une origine infectieuse
Rhinites ou sinusites peuvent entraîner des saignements de nez.
Des troubles de la coagulation, une hypertension artérielle ou la prise de médicaments (aspirine, anti-inflammatoires, anticoagulants…) sont également des facteurs déclenchants.
Un effort important, une grosse colère, une émotion forte, bref toute situation qui provoque une hausse brutale de la tension artérielle peut également être source d'une hémorragie nasale.

Comment réagir ?
Ne paniquez pas. Dans la majorité des cas et même s'il paraît spectaculaire, ce type de saignement est bénin. Contrairement à une idée reçue, ne penchez pas la tête en arrière. Même si cela semble limiter l'écoulement nasal, le sang continue en fait de couler dans la gorge.

Cela ne règle donc pas le problème…
En premier lieu, asseyez-vous et… détendez-vous. Mouchez-vous doucement afin d'évacuer les caillots. Pincez ensuite vos narines pendant une dizaine de minutes, pour permettre au sang de coaguler. Placez un linge froid ou un glaçon sur votre nez.

Enfin, évitez d'y insérer un tampon de coton. Préférez-lui des mèches coagulantes, disponibles en pharmacie et dont vous devriez toujours avoir une boîte à la maison. Et bien entendu, une fois le saignement terminé, ne vous mouchez pas et ne vous grattez pas les narines !

Dois-je consulter ?
Même si l'épistaxis est le plus souvent anodine, il peut être nécessaire de la mentionner à votre médecin traitant. Si le saignement est dû à un choc, s'il se prolonge, si vous êtes traité pour hypertension artérielle, si en parallèle vous souffrez de maux de tête, si vous êtes pris de vomissements… Une seule chose à faire : consulter sans attendre.

 

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