全麻控制性降压在鼻内镜手术中的应用优势

The Application Advantages of Controlled Hypotension in Nasal Endoscopic Surgery

目的针对鼻内镜手术,讨论全麻控制性降压的应用优势,为日后的临床手术提供参考与指导。方法方便选择2014年3月—2015年9月在该院行鼻内镜手术患者90例。随机划分为3组,观察组、对照1、2组。观察组实施全麻控制性降压下鼻内镜手术;对照1组实施粘膜表面+局部浸润麻醉下鼻内镜手术;对照2组实施常规全麻下进行鼻内镜手术。对比3组患者的术中出血量、手术时间、临床疗效。结果经统计,观察组、对照组1及2患者术中出血量为(105±56)m L、(192±77)m L、(263±102)m L,手术时间为(45±16)min、(60±18)min、(68±21)min;观察组术中出血量及手术时间均显著小于对照1、2组,P<0.05;观察组疗效判定总有效率为100.0%,对照1、2组为86.7%、83.3%,观察组与对照1、2组相比,差异有统计学意义,P<0.05。观察组患者优于对照1、2组。结论在全麻控制性降压下行功能性鼻内镜鼻窦手术(FESS),能够减少患者术中出血量,提高手术精度、疾病治愈率。

Objective to discuss the advantages of the application of controlled hypotension in general anesthesia for nasal endoscopic surgery, and provide reference and guidance for clinical operation. Methods Convenient selection 90 cases of patients with nasal endoscopic surgery in our hospital from March 2014 to September 2015 were selected. Randomly divided into 3 groups, the observation group, the control group 1, 2 groups. In the observation group, the implementation of the control of the nasal endoscopic surgery under general anesthesia, control 1 groups of the implementation of the mucosal surface＋ local infiltration anesthesia endoscopic sinus surgery; control 2 groups of routine anesthesia for nasal endoscopic surgery.The amount of bleeding, operation time and clinical effect of the 3 groups were compared. Results According to statistics,the observation group and the control group of 1 patients and 2 bleeding during operation was（105 ± 56）m L,（192 ± 7）m L,（263 ± 102）m L, the operation time was（45 ± 16）min,（60 ± 18）min,（68 ± 21）min; the amount of bleeding and operation time were significantly lower than the control group 1, 2. P〈0.05; the observation group curative effect to determine the total efficiency of 100%, 1, 2 in control group was 86.7%, 83.3%, 1, the observation group compared with the control group 2,the difference was statistically significant, P〈0.05. The observation group was better than the control group 1, 2 groups.Conclusion Functional endoscopic sinus surgery（FESS） under the control of general anesthesia can reduce the amount of bleeding during operation and improve the accuracy of operation and the cure rate of the disease.