鼻窦炎围手术期处理对术中出血、术后发热的影响

Study of bleeding and fever in endoscopic sinus surgery by preoperative treatment.

目的探讨慢性鼻窦炎鼻内镜手术围手术期处理对术中出血及术后发热的影响。方法采用前瞻性分析94例经内镜鼻窦手术治疗的慢性鼻窦炎鼻息肉患者术中出血和术后发热的情况,其中A组58例进行围手术期处理,并与B组36例未经围手术期处理的同类手术进行比较。结果围手术期处理组(A)术中出血量为(55.62±37.31)ml,未处理组(B)为(106.13±86.93)ml,两者间差异有统计学意义(P<0.05)。围手术期处理组术后发热占13.8%,未处理组术后发热占61.1%,两者间差异有统计学意义(P<0.05)。结论术前控制出血的高危因素,全身和局部药物治疗对减少术中出血起着关键作用,而术中应用适当的血管收缩剂及静脉输入止血药、避免不必要的损伤等对减少术中出血也起着重要作用;围手术期有效的抗感染对症处理对控制术后发热十分重要。

Objective To explore bleeding and fever by the influence of preoperative treatment during endoscopic sinus surgery.Methods Bleeding during endoscopic sinus surgery and fever after operation of 94 patients were analyzed.58 patients were treated before operation,and 36 patients were not dealed anything.Results The volume of bleeding during surgery in group A is（55.62±37.31）ml and group B is（106.13±86.93）ml.There is significant different between two groups（P0.05）.The fever after surgery is also significant difference（P0.05）.Conclusion The most important factors to reducing the volume of bleeding and fever are controlling the inflammatory reaction of chronic sinusitis and nasal polyp by preoperative treatment.The other factors such as use of vasoconstrictor while undergoing ESS,and reducing trauma during surgery were also important.