功能性鼻旁窦内窥镜手术分期处理的探讨

A Staged Functional Endoscopic Sinus Surgery by Two Stages

目的 :探讨减少功能性鼻旁窦内窥镜手术 (FESS)中的出血、解剖标志不清、视野模糊等现象 ,使手术更为安全、彻底的方法。方法 :对 2 7例慢性鼻旁窦炎患者在手术中采用“二步法”(即将鼻腔、鼻旁窦的病变分二期处理 ) ,并与同期采用常规方法 (即一次处理鼻腔、鼻旁窦病变 )治疗的 2 6例慢性鼻旁窦炎患者相比较。结果 :“二步法”组在内窥镜下处理鼻旁窦病变时出血减少 ,平均出血量为 15 3 .7ml,平均手术时间为 14 8.9min ,术后清理残留病变的次数为 5 .6次 ;而常规方法组的平均出血量为 196 .2ml,平均手术时间为 177.4min ,术后清理残留病变的次数为 7.8次。结论 :“二步法”有较大优越性 。

Objective The purpose of the functional endoscopic sinus surgery(FESS) by two stages was to diminish hemorrhage and prevent confusing anatomic sign and blurring visual field during operation.Method Twenty seven cases of chronic sinusitis were operated on using “this” method by which the lesions in nasal cavity and sinus were treated in two stages and compared to 26 cases of chronic sinusitis by routine method.Result In “two stages” group,bleeding was decreased,lens adhering and visual blurring was diminished.The mean blood loss was 153.7?ml,the mean operating time was 148.9 minutes,and the mean cleaning up of rudimental diseased tissue was 5.6 times while that in controls was 196.2?ml, 177.4 minutes and 7.8 times,respectively.Conclusion There is a great advantage in “two-stages” method,and it can be used as an effective measure in FESS.