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全身用类固醇药物术前用药对鼻-鼻窦内镜手术中手术视野出血及清晰度的影响。

Effect of premedication with systemic steroids on surgical field bleeding and visibility during nasosinusal endoscopic surgery.

作者信息

Fraire María E, Sanchez-Vallecillo María V, Zernotti Mario E, Paoletti Oscar A

机构信息

Departamento de Otorrinolaringología, Sanatorio Allende, Córdoba Capital, Córdoba, Argentina.

出版信息

Acta Otorrinolaringol Esp. 2013 Mar-Apr;64(2):133-9. doi: 10.1016/j.otorri.2012.09.009. Epub 2013 Jan 11.

Abstract

INTRODUCTION

Chronic rhinosinusitis (CRS) is the inflammation of the nasal and paranasal sinus mucosa persisting for at least 12 weeks. The success of endoscopic sinus surgery (ESS) depends on minimising oedema and intraoperative bleeding. For this purpose, some surgeons advocate the use of preoperative systemic steroids (SS). Our aim was to assess if the administration of preoperative SS in patients with CRS with or without nasal polyps (NP) facilitates the surgical procedure.

METHODS

Non-randomized clinical trial in CRS patients with or without NP. Patients in the ESS group received oral meprednisone preoperatively, whereas the control group did not. The visibility of the surgical field, intraoperative bleeding and surgery duration were recorded.

RESULTS

Each group (SS group and control group) included 27 patients. The administration of SS reduced the values of all the parameters in patients without NP, with no significant differences. In patients with NP, only operative bleeding was reduced significantly.

CONCLUSIONS

Even though all the parameters decreased with the preoperative administration of SS, only operative bleeding was significantly reduced in patients with CRS with NP.

摘要

引言

慢性鼻-鼻窦炎(CRS)是指鼻腔和鼻窦黏膜的炎症持续至少12周。鼻内镜鼻窦手术(ESS)的成功取决于尽量减少水肿和术中出血。为此,一些外科医生主张使用术前全身用类固醇(SS)。我们的目的是评估在有或无鼻息肉(NP)的CRS患者中给予术前SS是否有助于手术操作。

方法

对有或无NP的CRS患者进行非随机临床试验。ESS组患者术前接受口服甲泼尼龙,而对照组未接受。记录手术视野的可视性、术中出血情况和手术持续时间。

结果

每组(SS组和对照组)包括27例患者。SS的使用降低了无NP患者所有参数的值,但无显著差异。在有NP的患者中, 仅手术出血显著减少。

结论

尽管术前给予SS后所有参数均降低,但在有NP的CRS患者中只有手术出血显著减少。

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