Lee Ta-Jen, Huang Chi-Che, Chang Po-Hung, Chang Chee-Jen, Chen Yi-Wei
Department of Otolaryngology, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan.
Otolaryngol Head Neck Surg. 2009 Feb;140(2):209-14. doi: 10.1016/j.otohns.2008.09.029.
To determine the feasibility of the use of a topical vasoconstrictor for hemostasis during functional endoscopic sinus surgery.
Case-control study.
From May 1998 to August 2002, 226 patients (injection group) with bilateral chronic rhinosinusitis received an adrenaline injection for hemostasis during functional endoscopic sinus surgery at our tertiary referral center. After September 2002, topical adrenaline was applied for hemostasis in 226 consecutive patients (noninjection group) who underwent the same surgery. The two groups were matched by age, sex, body weight, stage of chronic rhinosinusitis, and pre-anesthesia blood pressure. The hemostatic effects in each group were analyzed.
No statistically significant differences in operation time and intraoperative blood loss were reached between the two groups of patients.
Topical use of adrenaline achieved similar hemostatic effect compared with injection of adrenaline. Intranasal injection of a vasoconstrictor, in consideration of its adverse effects, may be avoided during surgery.
确定在功能性鼻内镜鼻窦手术中使用局部血管收缩剂进行止血的可行性。
病例对照研究。
1998年5月至2002年8月,226例双侧慢性鼻窦炎患者(注射组)在我们的三级转诊中心接受功能性鼻内镜鼻窦手术时接受肾上腺素注射以止血。2002年9月之后,226例连续接受相同手术的患者(非注射组)使用局部肾上腺素进行止血。两组在年龄、性别、体重、慢性鼻窦炎分期和麻醉前血压方面进行匹配。分析每组的止血效果。
两组患者在手术时间和术中失血量方面未达到统计学显著差异。
与注射肾上腺素相比,局部使用肾上腺素取得了相似的止血效果。考虑到其不良反应,手术期间可避免鼻内注射血管收缩剂。