鼻骨骨折伴鼻中隔偏曲患者围术期应激反应分析

目的观察鼻骨骨折伴鼻中隔偏曲患者围术期创伤应激的变化情况。方法选取2015年4月至2016年5月行视频内镜下鼻中隔偏曲矫正联合鼻骨复住的41例患者为观察组，并选取此时间段的41名体检健康同龄者为对照组，然后检测对照组和观察组术前，术后12h、1d、3d、5d72．7d的血清应激激素、炎性应激及其他创伤应激指标进行比较。结果观察组术前至术后的血清应激激素、炎性应激指标及其他创伤应激指标水平均先升后降，且观察组术前，术后12h、1d、3d的血清应激激素及其他创伤应激指标水平均高于对照组，术前，术后12h、1d、3d、5d的炎性应激指标水平均高于对照组，P均〈0．05。结论鼻骨骨折伴鼻中隔偏曲患者围术期创伤应激的不良波动较大，应根据其不同时间点的变化情况给予监测及充分的干预。

Objective To observe the change situation of traumatic stress of patients with traumatic deflection of nasal septum during the perioperative period. Methods 41 patients with traumatic deflection of nasal septum who were treated with surgery in our hospital from April 2015 to May 2016 were selected as the observation group, 41 healthy persons of the same age with physical examination at the same time were selected as the control group, and then the serum hormones, inflammatory stress and other traumatic stress indexes of the two groups were compared before and after the surgery at 12th hour, 1st, 3rd, 5th and 7th day. Results The serum hormones, inflammatory stress and other traumatic stress indexes of observation group and after the surgery all increased at first and then were decreased compared with before the surgery, serum hormones and other traumatic stress indexes of observation group before and after the surgery at 12th hour, 1st and 3rd day were all higher than those of control group, and serum inflanunatory stress of observation group before and after the surgery at 12th hour, 1st, 3rd and 5th day were all no significant difference compared with the control group, P〈O.05. Conduslon In consideration of the adverse fluctuations of traumatic stress of patients with traumatic deflection of nasal septum during the perioperative period are greater, the change situation at different time should be paid to monitoring and enough intervention.