慢性鼻-鼻窦炎患者鼻内镜手术的全身并发症及其防治

发布时间：2018-01-27 12:41

本文关键词： 鼻窦炎功能性鼻内镜手术并发症　出处：《临床耳鼻咽喉头颈外科杂志》2014年20期 　论文类型：期刊论文

【摘要】：目的:探讨慢性鼻-鼻窦炎(CRS)患者鼻内镜手术的全身并发症发生原因及其防治措施。方法:报告3例典型病例,包括病史、术前诊断、围手术期用药情况、并发症及其处理情况等。分析并发症原因,并建立预防措施。结果:3例均为CRS伴鼻息肉患者,鼻内镜术后低钠低氯性昏迷1例,急性心肌梗死1例,下肢深静脉血栓1例。低钠低氯性昏迷患者在静脉滴注10%氯化钠后很快清醒;急性心肌梗死、下肢深静脉血栓患者经血管内介入紧急溶栓治疗后康复。3例患者均未遗留严重后遗症。结论:高凝状态患者鼻内镜围手术期应禁用全身止血药物以避免全身严重并发症,积极的血管介入治疗可避免严重后遗症。
[Abstract]:Objective: to investigate the causes of systemic complications in patients with chronic rhinosinusitis (CRS) and their preventive and therapeutic measures. Methods: three typical cases, including history and preoperative diagnosis, were reported. Results 3 cases of CRS with nasal polyps, 1 case of hyponatremia and 1 case of hypochloric coma after nasal endoscopy were analyzed and preventive measures were established. Acute myocardial infarction (AMI) and deep venous thrombosis (DVT) were found in 1 case. The patients with hyponatremia and hypochloric coma wake up quickly after intravenous drip of 10% sodium chloride. Acute myocardial infarction. There were no serious sequelae in 3 patients with deep venous thrombosis after emergency thrombolytic therapy. Conclusion:. In patients with hypercoagulability, systemic hemostats should be banned during the perioperative period of nasal endoscopy to avoid severe systemic complications. Active vascular intervention can avoid severe sequelae.
【作者单位】：解放军总医院耳鼻咽喉头颈外科;解放军163医院耳鼻咽喉头颈外科;
【分类号】：R765.9
【正文快照】： 慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)的主要手术方法是功能性鼻内镜手术(functionalendoscopic sinus surgery,FESS)。通过近三十年的发展,各种解剖学习训练班、国内外学术交流、CRS诊断和治疗指南等都大大促进了FESS疗效和安全性的提高〔1〕。虽然手术的局部并发症发

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