鼻内镜术后鼻出血相关因素分析

发布时间：2018-10-13 08:52

【摘要】：目的:探讨鼻内镜术后鼻出血的相关危险因素及其处理措施。方法:回顾性分析2011-2012年我科完成的641例鼻内镜手术的临床资料,并对围手术期可能与术后出血相关的因素进行单因素及非条件Logistic多因素分析。结果:鼻内镜术后出血的发生率为8.4%,单因素分析结果显示既往鼻内镜手术史、高血压病史以及长期服用非甾体抗炎药(NSAIDs)3个因素与鼻内镜术后出血的发生显著相关,多因素分析结果显示除了上述3个因素外,鼻中隔黏膜下矫正术及术前激素治疗亦为影响鼻内镜术后出血发生的独立因素(OR值分别为15.673、2.443、5.099、16.197和0.269)。结论:既往鼻内镜手术史,鼻中隔黏膜下矫正术、高血压病史、长期服用NSAIDs以及术前激素治疗是影响鼻内镜术后出血发生的独立因素,其中,术前激素治疗,平稳控制高血压病患者的血压以及停用NSAIDs 2周或以上可在一定程度上减少鼻内镜术后出血的风险,临床医师术前应根据患者的实际情况采取相应的措施以减少或避免术后出血的发生。
[Abstract]:Objective: to investigate the risk factors and management of epistaxis after endoscopy. Methods: the clinical data of 641 patients undergoing endoscopic sinus surgery from 2011 to 2012 were analyzed retrospectively. Univariate and unconditioned Logistic multivariate analysis were performed on the factors related to postoperative bleeding during perioperative period. Results: the incidence of bleeding after nasal endoscopy was 8.4%. Univariate analysis showed that the history of endoscopic sinus surgery, the history of hypertension and the long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) were significantly related to the occurrence of bleeding after nasal endoscopy. The results of multivariate analysis showed that, in addition to the above three factors, submucosal correction of nasal septum and preoperative hormone therapy were independent factors for the occurrence of bleeding after nasal endoscopy (OR = 15.673 卤2.443) and 5.099 ~ (16. 197) and 0.269 respectively. Conclusion: the history of nasal endoscopic surgery, submucosal correction of nasal septum, history of hypertension, long-term administration of NSAIDs and preoperative hormone therapy are independent factors affecting the occurrence of bleeding after nasal endoscopy. Stable control of blood pressure in patients with hypertension and cessation of NSAIDs for 2 weeks or more may reduce the risk of bleeding after endoscopic sinus surgery. The clinician should take corresponding measures to reduce or avoid postoperative bleeding according to the actual situation of the patients before operation.
【作者单位】：中南大学湘雅三医院耳鼻咽喉-头颈外科;
【分类号】：R765.23

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