功能性内镜鼻窦手术并发症临床分析和预防

Prevention and analysis of complications in functional endoscopic sinus surgery

目的分析功能性内镜鼻窦手术(FESS)并发症的相关因素和提出临床预防措施。方法 FESS手术376例,严格规定手术适应症和手术范围的情况下,分析并发症发生率和发生因素。结果本组手术并发症23例,发生率6.1％。术腔粘连或闭塞8例;术中出血和眼睑淤斑、肿胀各6例。3例严重并发症术中均为全麻,一过性复视、视力下降,鼻中隔穿孔,内直肌断离各1例。结论 FESS手术并发症相关因素包括再次手术,手术范围大,出血多、术野不清,解剖变异,原有眶壁缺损,操作熟练程度,术中全麻。谨慎仔细对待有相关因素术者,预防各类并发症的发生。

Objective To analyge the interrelated factors of complications of functional endoscopic sinus surgery (FESS) and put forward clinical prevention measures.Methods To Analyge the complications and cause of 376 FtSS cases with strict indication and resection extent.Results The over/all complications rate was 6.1%.8 adhesive and occlusion complications,6 bleeding and 6 periorbital ecchyosis,1 every tempotarydiplopia,perforation of nasal septum and medial rectus muscle broken.Conclusion relevant factors of complications of FESS include reoperation greater extent of operation,much bleed,no clear resection extent,anatomical change,originally possessed broken mural,level of practice proficiency,ete.So interrelated factors to prevent showld be dealt with carefully.