中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
5期
130-131
,共2页
慢性鼻窦炎鼻息肉%经鼻内镜鼻窦手术%并发症%防范
慢性鼻竇炎鼻息肉%經鼻內鏡鼻竇手術%併髮癥%防範
만성비두염비식육%경비내경비두수술%병발증%방범
Chronic sinusitisand nasal polyps%Endoscopic sinus surgery%Surgical complications%Aviodance
目的 探讨慢性鼻窦炎鼻息肉经鼻内镜鼻窦手术并发症发生的原因及其防范补救措施.方法 采用回顾性分析111例住院病例围术期观察和出院后随访观察,并对并发症防范及补救措施进行评价.结果 本组手术并发症总的为10例(9%).其中术中出血1例(1%),眶纸板及眶筋膜损发生2例(1.8%),内直肌损伤导致复视发生1例(1%),术腔粘连闭塞发生3例(2.7%),鼻中隔穿孔发生2例(1.8%),泪道损伤发生1例(1%);本组没有其他严重手术并发症的发生.结论 鼻内镜鼻窦手术(FSS)并发症在临床上并不少见,应高度重视;严格筛选手术适应证,规范化的围术期用药和处理,术前仔细检查患者和阅读CT片,术后定期随访,适时采取补救措施,对降低手术并发症的发生和保障医疗安全十分重要.
目的 探討慢性鼻竇炎鼻息肉經鼻內鏡鼻竇手術併髮癥髮生的原因及其防範補救措施.方法 採用迴顧性分析111例住院病例圍術期觀察和齣院後隨訪觀察,併對併髮癥防範及補救措施進行評價.結果 本組手術併髮癥總的為10例(9%).其中術中齣血1例(1%),眶紙闆及眶觔膜損髮生2例(1.8%),內直肌損傷導緻複視髮生1例(1%),術腔粘連閉塞髮生3例(2.7%),鼻中隔穿孔髮生2例(1.8%),淚道損傷髮生1例(1%);本組沒有其他嚴重手術併髮癥的髮生.結論 鼻內鏡鼻竇手術(FSS)併髮癥在臨床上併不少見,應高度重視;嚴格篩選手術適應證,規範化的圍術期用藥和處理,術前仔細檢查患者和閱讀CT片,術後定期隨訪,適時採取補救措施,對降低手術併髮癥的髮生和保障醫療安全十分重要.
목적 탐토만성비두염비식육경비내경비두수술병발증발생적원인급기방범보구조시.방법 채용회고성분석111례주원병례위술기관찰화출원후수방관찰,병대병발증방범급보구조시진행평개.결과 본조수술병발증총적위10례(9%).기중술중출혈1례(1%),광지판급광근막손발생2례(1.8%),내직기손상도치복시발생1례(1%),술강점련폐새발생3례(2.7%),비중격천공발생2례(1.8%),루도손상발생1례(1%);본조몰유기타엄중수술병발증적발생.결론 비내경비두수술(FSS)병발증재림상상병불소견,응고도중시;엄격사선수술괄응증,규범화적위술기용약화처리,술전자세검사환자화열독CT편,술후정기수방,괄시채취보구조시,대강저수술병발증적발생화보장의료안전십분중요.
Objective To analyze the surgical complication in patients with chronic sinusitis and nasal polyps,and discuss the risk factors and preliminary strategies for prevention of complications.Methods Review the surgical complication in patients with chronic sinus and nasal polyps after endoscopic sinus surgery(ESS).All patients were followed-up more than 6 months.Results There were 9% cases(10/111)had surgical complications after ESS,which include bleeding in 1 case(1%),orbital complications in 2 cases(1.8 %),diplopia in 1 case(1%),nasal bind in 3 case(2.7%),perforation of nasal septum in 2 cases(1.8%),harm of nasolacrimal duct in 1 case(1%).Conclusion It is more that occur rate of surgical complication due to ESS than traditional operation.Peri-operative complications are more common in nasal polyps and severe chronic sinusitis patients,especially when they accompanied with hypertension.The corresponding strategies should be taken to reduce complications in ESS,which include controlling the hypertension effectively,selecting the indication suitable to ESS,reading to CT before operation,monitoring closely after operation.It is important to reduce surgical skills and not enlarging the surgical scale blindly.
