经鼻内镜下上颌窦根治术围术期的护理

Perioperative Care in Radical Transnasal Endoscopic Surgery for Maxillary Sinus Lesions

目的探讨上颌窦病变患者经鼻内镜下行上颌窦根治术围术期的护理。方法将120例上颌窦病变患者按随机数字表法分为对照组与观察组,每组60例。2组均采用传统的柯-陆手术进路与鼻内镜手术联合治疗。对照组手术前后给予常规护理;观察组在对照组常规护理基础上加强对患者的健康教育心理护理和并发症的预防等围术期护理。对2组患者手术时间、出血量、术后镇痛剂使用、术后并发症、住院时间及护理工作的满意度进行比较。结果观察组手术时间、出血量、术后镇痛剂使用率、住院费用均显著低于对照组,患者对护理满意度明显高于对照组(均P<0.05)。观察组术后并发症(鼻出血、眶内血肿、鼻腔粘连等)发生率明显低于对照组(P<0.05)。结论对上颌窦病变患者经鼻内镜下行上颌窦根治术,有针对性地做好患者术前心理护理、术前准备,术后严密观察患者体征变化,有效地采取护理预防措施,加强健康宣教及术后鼻腔冲洗和随访,是确保患者手术安全、成功、顺利康复的重要保障。

Objective To investigate the perioperative care in radical transnasal endoscopic treatment of maxillary sinus lesions. Methods A total of 120 patients with maxillary sinus lesions were randomly divided into two groups, with 60 patients in each group. All patients were treated with traditional Caldwell-luc operation and transnasal endoscopic surgery. The control group was given conventional care before and after treatment. The observation group was given health education, complication prevention and other perioperative care strategies on the basis of conventional care. The operative time, amount of bleeding, postoperative analgesic use, postoperative complications, hospital stays and patient satisfaction with nursing care were compared between the two groups. Results Compared with control group, the perioperative care significantly decreased the operative time, amount of bleeding, postoperative analgesic use, postoperative complications （epistaxis, intraorbital hematoma and nasal adhesion） and hospitalization costs and obviously increased patient satisfaction with nursing care （all P〈0.05）. Conclusion Preoperative psychological care, preoperative preparation, postoperative sign monitoring, effective preventive measures, health education, postoperative nasal irrigation and follow-up survey are important for safe operation and successful rehabilitation in patients undergoing radical transnasal endoscopic surgery for maxillary sinus lesions.