局麻下经鼻内镜对鼻部复合病变的治疗

Treatment of complex lesions of the nose by nasal endoscopy under local anesthesia

目的介绍局麻下经鼻内镜对鼻部复合病变的治疗。方法总结116例(184侧)慢性鼻窦炎、鼻息肉合并鼻中隔偏曲、肥厚性鼻炎复合病变的患者在局麻下经鼻内镜手术治疗。结果 116例中,治愈88例(75.8%),好转24例(20.7%),无效4例(3.4%);并发症8例。手术麻醉效果优良84例(72.4%),较好30例(25.9%),差2例(1.7%)。结论鼻内镜手术治疗慢性鼻窦炎、鼻息肉合并鼻中隔偏曲、肥厚性鼻炎的复合病变疗效显著,可一次完成手术。在基层医院开展此手术时要做好术前检查、术前准备,有条件者尽量做鼻窦CT冠位扫描,对手术有指导意义;97%的患者可以用局部麻醉方法,且效果较好,术后综合治疗及定期复查是防止并发症保证治愈率的重要措施。

Objective To demonstrate the treatment for complex lesions of the nose by nasal endoscopy in the condition of local anesthesia.Methods The treatments by endoscopic surgery under local anesthesia for 116 cases（184 sides） with chronic sinusitis,nasal polyps merged with deviated nasal septum,composite lesions of the hypertrophic rhinitis are summarized.Results In 116 cases,88 cases（75.8%） were cured,24 cases（20.7%） were improved,4 cases（3.4%） were invalid,and eight cases were accompanied by complications.The anesthesia effect was fine in 84 cases（72.4%）,good in 30 cases（25.9%） and poor in two cases（1.7%）.Conclusion Endoscopic sinus treatment in one operation exhibits significant curative impacts on chronic sinusitis,nasal polyps merged with deviated nasal septum,composite lesions of the hypertrophic rhinitis.It should be noted that the examination and preparation before operation are necessary in primary hospital,and a CT scan for sinus coronal can guide the surgery.The local anesthesia is effective for over 97% of patients.The meticulous postoperative treatment and periodic review are important to ensure the cure rate and prevent complications.