上颌窦内窥镜手术中加大腭大管注射对估计失血量的影响。

Effect of greater palatine canal injection on estimated blood loss during endoscopic sinus surgery.

机构信息

Department of Otolaryngology-Head & Neck Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA; Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA.

出版信息

Am J Otolaryngol. 2014 Jan-Feb;35(1):1-4. doi: 10.1016/j.amjoto.2013.02.011. Epub 2013 Mar 23.

DOI:10.1016/j.amjoto.2013.02.011

PMID:23529136

Abstract

PURPOSE

We compare estimated blood loss (EBL) during endoscopic sinus surgery (ESS) between patients receiving transoral greater palatine canal (GPC) and transnasal infiltration (combined group) to patients receiving only transnasal infiltration (control group). CT stage, endoscopic stage, revision surgery, presence of polyps, degree of resident involvement, and operative time (OT) are also evaluated.

METHODS

Injection with 1% lidocaine with 1:100,000 epinephrine was performed through the GPC and transnasally in the "combined" study group (20 patients) and only transnasally in the control group (22 patients). Charts, operative reports, and CT scans were reviewed and demographic data as well as pertinent information collected. Data analysis was performed using SPSS Version 16 (SPSS Inc., Chicago, Illinois).

RESULTS

Twelve females and 8 males underwent combined injections and 16 males and 6 females received transnasal injections only. Average ratio of EBL to OT was 2.9 mL/min for the combined group and 4.1 mL/min for the control group (p=0.05). Presence of polyps and revision surgery lead to a statistically significantly higher EBL (p<0.05). Increased EBL and OT were noted with higher endoscopic and CT stages. No complications were reported.

CONCLUSIONS

Increased endoscopic and CT stages, presence of polyps, and revision surgery may all lead to greater EBL in ESS. Although there was a trend towards decreased EBL in the combined group, this however did not reach statistical significance. Combined injection through the GPC and nasal cavity appears to be a safe method to decrease EBL during ESS.

摘要

目的

我们比较了接受经口上颌后腔（GPC）和经鼻内浸润（联合组）与仅接受经鼻内浸润（对照组）的内镜鼻窦手术（ESS）患者的估计失血量（EBL）。还评估了 CT 分期、内镜分期、翻修手术、息肉存在、居民参与程度和手术时间（OT）。

方法

在“联合”研究组（20 例）中通过 GPC 和经鼻内注射 1%利多卡因加 1:100000 肾上腺素，在对照组（22 例）中仅经鼻内注射。回顾图表、手术报告和 CT 扫描，并收集人口统计学数据和相关信息。使用 SPSS 版本 16（SPSS Inc.，芝加哥，伊利诺伊州）进行数据分析。

结果

12 名女性和 8 名男性接受联合注射，16 名男性和 6 名女性仅接受经鼻内注射。联合组 EBL 与 OT 的平均比值为 2.9 mL/min，对照组为 4.1 mL/min（p=0.05）。息肉存在和翻修手术导致 EBL 统计学上显著增加（p<0.05）。内镜和 CT 分期越高，EBL 和 OT 增加。未报告并发症。