鼻窦手术术式选择、术中出血与手术效果探讨  

Exploration on operation methods option,bleeding during operation in sinusitis and operation effect

作　　者：陈奕辉[1] 王海茹[1] 龙绮[1] 

机构地区：[1]海口市人民医院耳鼻喉科,海南海口570208

出　　处：《现代预防医学》2012年第24期6508-6509,共2页Modern Preventive Medicine

摘　　要：目的探讨鼻窦手术方式选择、手术中出血与手术效果的关系,以提高手术的效果。方法将病例随机分为A组与B组,分别采用行柯-陆氏术式与鼻窦内窥镜术式进行手术,对结果进行分析比较。结果两组手术治愈率差异无统计学意义(P﹥0.01),而因术中出血致手术失败,鼻内镜手术组有3例,达3.70%,柯-陆氏手术组无失败病例。结论对Ⅰ、Ⅱ型鼻窦炎,鼻内窥镜手术具有微创的优点,但对Ⅲ型鼻窦炎、骨质硬化型,内翻性乳头状瘤等病变,采用鼻内镜手术易致出血过多,甚至失败,而采用柯-陆氏手术具有术野宽、可比较快地于净彻底清理病变组织,安全性相对增高,缺点是手术创伤大,术后颌面部肿胀,有麻木感。术前估计术中出血较多时,可采用联合术式。通过合理的术式选择,既可以比较干净彻底清除病灶,又可以避免或减轻并发症,提高手术效果及安全性。OBJECTIVE Through exploring on the operation methods, bleeding during operation in sinusitis and operation ef- fect, to improve the success rate of operations. METHODS Divided the cases randomly into endoscopic method group and Caldwell-Luc method group, analyzed the result and made a comparison between the two methods. RESULTS In results, the cure rate was not apparently different between two groups （P 〉 0.01） , but the failure rate caused by bleeding in endoscopic method group was 3.7%, comparing with Caldwell-Luc method group with no failure cases. CONCLUSION Aiming at type Ⅰ or Ⅱ sinusitis, endoscopic method has the advantage of microinvasive. But in the case of type Ⅲ sinusitis, endoscopic method will cause bleeding easily leading to operation failure in bone-hardening, inverted papilloma and other lesions. And Caldwell- Luc method has wild operational sight and can clear the lesion tissue thoroughly and improve the safety rate, but its weakness is severe trauma, face swelling and numb after the operation. If predicting much bleeding during the operation, the combined method is a good choice. Adopting reasonable methods can not only clear the nidus thoroughly but also avoid or reduce the complication so as to improve the effect and its safety.

关 键 词：鼻窦 术武 效果 

分 类 号：R765[医药卫生—耳鼻咽喉科]