全麻控制性降壓在鼻內(nèi)鏡手術(shù)中的應(yīng)用優(yōu)勢(shì)

[摘要] 目的 針對(duì)鼻內(nèi)鏡手術(shù)，討論全麻控制性降壓的應(yīng)用優(yōu)勢(shì)，為日后的臨床手術(shù)提供參考與指導(dǎo)。 方法 方便選擇2014年3月—2015年9月在該院行鼻內(nèi)鏡手術(shù)患者90例。隨機(jī)劃分為3組，觀察組、對(duì)照1、2組。觀察組實(shí)施全麻控制性降壓下鼻內(nèi)鏡手術(shù)；對(duì)照1組實(shí)施粘膜表面+局部浸潤(rùn)麻醉下鼻內(nèi)鏡手術(shù)；對(duì)照2組實(shí)施常規(guī)全麻下進(jìn)行鼻內(nèi)鏡手術(shù)。對(duì)比3組患者的術(shù)中出血量、手術(shù)時(shí)間、臨床療效。 結(jié)果 經(jīng)統(tǒng)計(jì)，觀察組、對(duì)照組1及2患者術(shù)中出血量為（105±56）mL、（192±77）mL、（263±102）mL，手術(shù)時(shí)間為（45±16）min、（60±18）min、（68±21）min；觀察組術(shù)中出血量及手術(shù)時(shí)間均顯著小于對(duì)照1、2組，P<0.05；觀察組療效判定總有效率為100.0%，對(duì)照1、2組為86.7%、83.3%，觀察組與對(duì)照1、2組相比，差異有統(tǒng)計(jì)學(xué)意義，P<0.05。觀察組患者優(yōu)于對(duì)照1、2組。 結(jié)論 在全麻控制性降壓下行功能性鼻內(nèi)鏡鼻竇手術(shù)（FESS），能夠減少患者術(shù)中出血量，提高手術(shù)精度、疾病治愈率。

[關(guān)鍵詞] 鼻內(nèi)鏡手術(shù)；出血；全麻；降壓

[中圖分類號(hào)] R614 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2016）11（a）-0097-03

[Abstract] Objective to discuss the advantages of the application of controlled hypotension in general anesthesia for nasal endoscopic surgery， and provide reference and guidance for clinical operation. Methods Convenient selection 90 cases of patients with nasal endoscopic surgery in our hospital from March 2014 to September 2015 were selected. Randomly divided into 3 groups， the observation group， the control group 1， 2 groups. In the observation group， the implementation of the control of the nasal endoscopic surgery under general anesthesia， control 1 groups of the implementation of the mucosal surface + local infiltration anesthesia endoscopic sinus surgery； control 2 groups of routine anesthesia for nasal endoscopic surgery. The amount of bleeding， operation time and clinical effect of the 3 groups were compared. Results According to statistics， the observation group and the control group of 1 patients and 2 bleeding during operation was（105 ± 56）mL， （192 ± 7）mL， （263 ± 102）mL， the operation time was （45 ± 16）min， （60 ± 18）min， （68 ± 21）min； the amount of bleeding and operation time were significantly lower than the control group 1， 2. P < 0.05； the observation group curative effect to determine the total efficiency of 100%， 1， 2 in control group was 86.7%， 83.3%， 1， the observation group compared with the control group 2， the difference was statistically significant， P < 0.05. The observation group was better than the control group 1， 2 groups. Conclusion Functional endoscopic sinus surgery （FESS） under the control of general anesthesia can reduce the amount of bleeding during operation and improve the accuracy of operation and the cure rate of the disease.

[Key words] Endoscopic sinus surgery；Bleeding； General anesthesia；Blood pressure

從臨床上分析，鼻內(nèi)鏡直視下開展鼻竇開放手術(shù)，是臨床上常見的方法。但是，多數(shù)患者的鼻竇血管表現(xiàn)為豐富的狀態(tài)，同時(shí)還會(huì)毗鄰一些非常重要的結(jié)構(gòu)[1-2]。這就要求在操作過程中，各項(xiàng)手術(shù)內(nèi)容都必須達(dá)到精確的特點(diǎn)，尤其是在手術(shù)視野上，必須格外的清晰，能夠?qū)颊呒皶r(shí)的進(jìn)行止血處理。鼻內(nèi)鏡手術(shù)，是當(dāng)前的主流術(shù)式，具備操作簡(jiǎn)單、視野清晰、出血量少的特點(diǎn)。文章方便選擇2014年3月—2015年9月在該院行鼻內(nèi)鏡手術(shù)患者90例為研究對(duì)象，針對(duì)全麻控制性降壓在鼻內(nèi)鏡手術(shù)中的應(yīng)用展開討論，現(xiàn)報(bào)道如下?！?br>