肾上腺素盐水鼻腔冲洗对功能性鼻内镜手术中视野和出血的影响  

Effect of nasal irrigation with adrenaline saline on visual field and bleeding during functional endoscopic sinus surgery

作　　者：康尧杰 廖勇 KANG Yaojie;LIAO Yong(Department of Otolaryngology Head and Neck Surgery,Central Hospital of Enshi Autonomous Prefecture,Enshi 445000,China)

机构地区：[1]湖北省恩施土家族苗族自治州中心医院耳鼻咽喉头颈外科,恩施445000

出　　处：《中国眼耳鼻喉科杂志》2023年第6期480-483,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的 探讨功能性鼻内镜手术(FESS)术中使用肾上腺素盐水行鼻腔冲洗对手术视野和出血的影响。方法 采用前瞻性随机对照研究方法。收集80例接受FESS的患者,随机分为生理盐水组(对照组)和肾上腺素盐水组(观察组)各40例,术中分别使用0.9%氯化钠(生理盐水)和1∶100 000肾上腺素盐水行鼻腔冲洗。采用鼻窦CT扫描Lund-Mackay(LM)评分法、Boezaart分级量表和视觉模拟评分(VAS)量表对2组的手术视野质量、术者对手术视野的满意度进行评分,并比较2组的出血量和围手术期血流动力学相关指标。结果 2组之间的各项观察指标差异均无统计学意义(P值均>0.05)。所有手术均顺利完成,无术中心血管事件和手术并发症发生。在鼻窦CT扫描LM评分>12分的患者中,观察组[(97.00±31.00)mL]的出血量少于对照组[(129.00±42.00) mL],差异有统计学意义(P=0.031)。结论 FESS中使用1∶100 000肾上腺素盐水行鼻腔冲洗是安全的,对血流动力学影响小,无手术并发症发生,可减少LM评分>12分患者的出血量,但在手术视野质量和术者对手术视野满意度方面未见明显优势。Objective To explore the effects of nasal irrigation with adrenalin-saline in functional endoscopic sinus surgery(FESS)on the surgical field and blood loss.Methods This was a prospective randomized controlled study.Eighty patients who had undergone FESS were collected and randomly assigned to the saline group(nasal irrigation with 0.9%sodium chloride,control group)or the adrenalin-saline group(nasal irrigation with 1∶100000 adrenalin-saline,observation group)with each including 40 patients.For both groups,the Boezaart grading scale and visual analogue scale(VAS)were used to score the surgical field quality and operator satisfaction with the surgical field,respectively,and the blood loss and the relevant perioperative hemodynamic variables were compared.Results There were no statistically significant differences between the two groups in any study variables(P>0.05).All surgeries were completed successfully without intraoperative cardiovascular events or surgical complications,while among the patients with LM score>12,blood loss was smaller in the treatment group[(97.00±31.00)mL]than that in the control group[(129.00±42.00)mL],with a statistically significant difference(P<0.05).Conclusion Intraoperative nasal irrigation with 1∶100000 adrenalin-saline in FESS was safe,with small hemodynamic effects and no surgical complications,which reduced blood loss in patients with LM score>12,while there was no significant advantages whether in the surgical field quality or in the operator satisfaction with the surgical field.

关 键 词：肾上腺素盐水 鼻腔冲洗 手术视野 出血 

分 类 号：R765[医药卫生—耳鼻咽喉科]