合并心血管疾病患者鼻内镜围手术期的治疗

Clinical treatment experience of perioperative nasal endoscopic surgery in patients with cardiovascular disease

目的:探讨合并心血管疾病的鼻科患者鼻内镜手术围手术期的处理措施。方法:对62例合并心血管疾病的鼻科患者进行鼻内镜手术治疗,根据患者围手术期病情采用个体化内科处理措施,然后行功能性鼻内镜手术。结果:2例患者鼻内镜术后出现心血管并发症,转内科治疗;1例患者术后大出血,再次全身麻醉鼻内镜下手术止血;余59例患者术后未见不良心血管事件,且无大出血、视力损伤、脑脊液鼻漏等并发症。所有患者术后均随访半年以上,鼻腔鼻窦病情完全控制39例(62.90%),部分控制18例(29.03%),有效率达91.94%。结论:合理的围手术期处理措施可以降低合并心血管疾病患者鼻腔鼻窦手术风险、确保手术顺利实施并取得良好的预后。

Objective: To investigate the perioperative management of endoscopic nasal surgery in patients with cardiovascular disease. Method: Sixty-two patients with cardiovascular disease underwent endoscopic sinus surgery. Individualized medical treatment was used according to the patient’s perioperative condition, followed by functional endoscopic surgery. Result: Two patients had cardiovascular complications after endoscopic surgery and were transferred to internal medicine. One patient developed massive hemorrhage after operation, and hemostasis was performed again under nasal endoscopic surgery. The remaining 59 patients had no adverse cardiovascular events after operation. There are no complications such as massive hemorrhage, visual impairment, and cerebrospinal fluid rhinorrhea. All patients were followed up for more than half a year, 39 cases(62.90%) of nasal sinus disease were completely controlled, 18 cases(29.03%) of nasal sinus disease were partially controlled, and the effective rate was 91.94%. Conclusion: Reasonable perioperative management measures can reduce the risk of nasal sinus surgery in patients with cardiovascular disease, ensure the successfully implementation of surgery and achieve a successful prognosis.