Lund-Mackay评分与内镜鼻窦手术出血的关系

Correlationship between Lund-Mackay and bleeding of endoscopic sinusitis surgery

目的探讨慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)行鼻内镜鼻窦开放术(ESS)时手术中出血量与疾病严重程度的客观参数间的关系。方法前瞻性分析60例CRSwNP患者Lund-Kennedy评分和鼻窦Lund-Mackay评分及术中出血量,进行相关性分析。结果鼻内镜下Lund-Kennedy评分为(2.73±0.95);鼻窦Lund-Mackay评分为(15.6±5.05),术中出血量为(199.0±94.0)mL。Lund-Kennedy评分与Lund-Mackay评分明显相关,Lund-Mackay评分与术中出血量也明显相关。结论Lund-Mackay评分可用于预测ESS术中出血量,术前规范化治疗和采用全麻控制性降压可以减少出血量和并发症产生。

[Objectives] To assess the correlationship between intraoperativ6 bleeding during endoscopic sinusitis surgery （ESS） for chronic rhinosinusitis with nasal polyps （CRSwNP） and objective parameters of disease severity. [Methods] A prospective cohort of 60 CRS patients treated by ESS was analyzed. Polyp size and CT scan opacifications were noted. The intraoperative blood loss was measured. The Spearman test was used to correlate these data. [Results] On nasal endoscopy, the Lund-Kennedy score was （2.73±0.95）. On CT scan, the Lund-Mackay grading was （15.6±5.05）. The intraoperative blood loss was （199±94） mL. A significant positive correlation was found between the Lund-Mackay score and the blood loss, also was found between the Lund-Kennedy score and the Lund- Mackay. [Conclusions] The Lund-Mackay CT score is useful in predicting intraoperative bleeding during ESS. Some specific measures like preoperative normalization treatment and hypotensive anesthesia could help to reduce the blood loss and the risk of intraoperative complications during ESS.