目标血压管理在全身麻醉鼻内镜下难治性鼻出血出血点定位中的应用

Application of target blood pressure management in the location of intractable epistaxis under nasal endoscope during general anesthesia

目的探讨目标血压管理在全身麻醉鼻内镜下难治性鼻出血出血点定位中的应用价值。方法选择全身麻醉中鼻内镜下未见明显出血点的难治性鼻出血患者58例,采用随机数字表法将所有患者分为对照组和观察组各29例。观察组行目标血压管理,控制性升压[目标血压不超过基础血压的120%且目标收缩压不得超过180 mmHg(1 mmHg=0.133kPa)],精确定位出血点,予电凝灼烧;对照组按常规行鼻腔选择性填塞术。记录观察组成功定位出血点例数,分别记录2组的住院时间、再出血例数、并发症例数。结果观察组的住院时间、再出血率、并发症发生率与对照组比较差异均有统计学意义(P值均<0.05)。结论目标血压管理在全身麻醉鼻内镜下难治性鼻出血出血点定位中的应用是行之有效的技术手段。

Objective To investigate the value of target blood pressure management in the location of intractable epistaxis under nasal endoscope during general anesthesia.Methods Fifty-eight patients with intractable epistaxis without significant bleeding point under nasal endoscope during general anesthesia were enrolled in the study.The patients were divided into observation group and contrast group by random number table method,with 29 cases in each group.The number of successful location of bleeding points in observation group was recorded,and the hospitalization time,recurrence rate during the follow up period,incidence of complications were compared between the two groups.Results The hospitalization time of observation group was shorter than contrast group.The recurrence rate during the follow up period and incidence of complications were significantly lower in the observation group than those in contrast group(P<0.05).Conclusions Target blood pressure management is an effective technique for the location of intractable epistaxis under nasal endoscope during general anesthesia.