鼻窦内镜鼻窦手术的术中监护

Consecutive monitoring in endoscopic sinus surgery

目的 探讨局麻下鼻窦内镜手术中各环节的监护重点 ,为手术的顺利进行提供有力保障。方法 对 1 0 0 0例在局麻下行鼻窦内镜手术病人进行术中监护 ,逐一记录局部麻醉剂用量、术中出血量、监护仪持续监测心率、血压及血氧饱和度等指标。结果 1例出现轻度丁卡因中毒症状 ;951例出血量为 80～ 40 0ml,占 95 1 % ,47例为 50 0～ 60 0ml,4 7% ,2例出血量为 82 0ml,占0 2 %。心动过速 2例 ,占 0 2 %。

Objective To explore the major points of monitoring in endoscopic sinus surgery to afford effective assistance for successful operation. Methods Consecutive operative monitorings were performed on 1 000 patients undergoing endoscopic sinus surgery under local anesthesia. In all cases, dosage of anesthetic, volume of operative bleeding and parameters measured by monitor (heart rate, blood pressure, oxygen saturation etc.) were recorded during the operation. Results Slight symptoms of dicaine intoxication occurred in 1 case under safe dosage. Bleeding varied from 80-400 ml in 951 cases (95.1%), 500-600 ml in 47 cases (4.7%), only 2 cases were about 820 ml (0.2%). And 2 cases of tachycardia were recorded (0.2%). Conclusion Reasonable and meticulous monitoring during operation is confirmed to be one of the key contributors for operation success.