硝普钠超前控制性降压在鼻内镜手术中的应用

Application on the Advanced Controlled Hypotension of Sodium Nitroprusside in Nasal Endoscopic Surgery

目的:探究硝普钠超前控制性降压在鼻内镜手术中的应用效果。方法:选取2018年1月-2019年5月本院80例行鼻内镜手术患者临床资料进行回顾性分析,按不同的降压方法分为对照组(常规降压)与试验组(硝普钠超前控制性降压),各40例。比较两组麻醉前后的血气分析指标、心肌酶谱及肾功能指标、降压后不同时间的术野质量、术中出血量、手术时间及硝普钠用量、并发症发生情况。结果:麻醉前、降压10 min及停止降压后10 min两组血气分析指标比较,差异均无统计学意义(P>0.05)。麻醉前及术后即刻、术后24 h两组心肌酶谱及肾功能指标比较,差异均无统计学意义(P>0.05)。降压后不同时间试验组的术野质量均优于对照组(P<0.05)。试验组术中出血量与硝普钠用量均低于对照组,且手术时间短于对照组(P<0.05)。两组均未出现并发症。结论:硝普钠超前控制性降压在鼻内镜手术中的应用效果较好,可有效改善术野质量,具有较高的应用安全性。

Objective: To investigate the application effect of advanced controlled hypotension of Sodium Nitroprusside in nasal endoscopic surgery. Method: Clinical data of 80 patients underwent endoscopic surgery in our hospital from January 2018 to May 2019 were retrospectively analyzed. According to different hypotension methods, they were divided into control group(conventional hypotension) and experimental group(advanced controlled hypotension of Sodium Nitroprusside), 40 cases in each group. The blood gas analysis indexes, myocardial enzymogram and renal function indexes before and after the anaesthesia, operative field quality at different time after the controlled hypotension, intraoperative blood loss, operation time and Sodium Nitroprusside dosage, complications situation of two groups were compared. Result: There was no significant difference in blood gas analysis indexes between the two groups before anesthesia, 10 min after hypotension and 10 min after cessation of hypotension(P>0.05). There were no significant difference in myocardial enzymogram and renal function indexes between the two groups before anesthesia, immediately and 24 h after surgery(P>0.05). The operative field quality at different time after hypotension of the experimental group were better than those of the control group(P<0.05). The intraoperative blood loss and Sodium Nitroprusside dosage of the experimental group were lower than those of the control group, and the operative time was lower than that of the control group(P<0.05). No complications occurred in either group. Conclusion: The application of advanced controlled hypotension of Sodium Nitroprusside in nasal endoscopic surgery has a good effect. It can effectively improve the quality of operative field and has higher application safety.