Iftikhar Saira, Jawad Ayesha, Umar Mumtaz Ahmad, Ahmed Farhan, Shafqat Maimoona, Naveed Seema
Shifa College of Medicine, Islamabad-Pakistan.
Islamabad Medical and Dental College, Islamabad-Pakistan.
J Ayub Med Coll Abbottabad. 2024 Jul-Sep;36(3):564-568. doi: 10.55519/JAMC-03-13602.
An inflammation of the nasal and paranasal sinus mucosa that lasts longer than three months is known as chronic rhinosinusitis. When corticosteroids and other medicinal treatments fail to relieve a patient's symptoms, then functional endoscopic sinus surgery (FESS) is a commonly performed procedure to alleviate the symptoms. The aim of the study was to evaluate the impact of oral steroids given prior to surgery on intraoperative bleeding in patients having functional endoscopic sinus surgery for chronic rhinosinusitis.
The study was conducted in ENT Department of Shifa Foundation Community Health Centre (SFCHC) and Shifa International Hospital (SIH) Islamabad, in a period of three years from June 2019 to June 2021. A total of 72 patients consisting of 36 patients in study group and 36 in control group, fulfilling the inclusion criteria were included in the study. Per-operative bleeding was assessed by measuring the amount of blood collected in suction bottle at the end of the procedure (the amount of saline used during the procedure was subtracted) and the number of surgical gauzes stained with blood (1 partially stained gauze = 5 ml and 1 completely stained gauze = 10 ml). The surgeon performing the surgery was unaware of the study group of the patient. All the collected data was entered and analyzed with SPSS v. 25.
The mean age of group A (35.39±13.86 vs. 29.83±15.86, p-value > 0.05) was similar to group B. There was male dominance in both group (69.4% vs. 72%) males in group A and group B. Nasal obstruction and nasal discharge was observed in all patients of both groups. Post nasal drip (88.9% vs. 88.9%), headache (97.2% vs. 91.7%) and facial pain (97.2% vs. 94.4%) was present in majority patients of both groups without any significant (p-value >0.05) difference. Both the groups were compared on the basis of amount of blood loss per-operatively and it was seen that the mean blood loss in group A was (164.03±42.99 ml) significantly (p-value <0.05) lower as compared to (215.83±39.397 ml) in group B.
This study showed that individuals with nasal polyps receiving preoperative steroids could successfully lower their perioperative morbidity, specifically intraoperative haemorrhage, after undergoing functional endoscopic sinus surgery.
鼻和鼻窦黏膜炎症持续超过三个月被称为慢性鼻窦炎。当皮质类固醇和其他药物治疗无法缓解患者症状时，功能性鼻内镜鼻窦手术（FESS）是一种常用的缓解症状的手术。本研究的目的是评估慢性鼻窦炎患者在功能性鼻内镜鼻窦手术前口服类固醇对术中出血的影响。
本研究于2019年6月至2021年6月在伊斯兰堡的希法基金会社区健康中心（SFCHC）和希法国际医院（SIH）的耳鼻喉科进行，为期三年。共有72例患者纳入研究，其中研究组36例，对照组36例，均符合纳入标准。通过测量手术结束时吸引瓶中收集的血量（减去手术过程中使用的生理盐水的量）和被血污染的手术纱布数量（1块部分染色的纱布 = 5毫升，1块完全染色的纱布 = 10毫升）来评估术中出血情况。实施手术的外科医生不知道患者所属的研究组。所有收集的数据均输入SPSS v. 25进行分析。
A组的平均年龄（35.39±13.86对29.83±15.86，p值>0.05）与B组相似。两组均以男性为主（A组69.4%，B组72%）。两组所有患者均有鼻塞和流涕症状。两组大多数患者均有鼻后滴漏（88.9%对88.9%）、头痛（97.2%对91.7%）和面部疼痛（97.2%对94.4%），且无显著差异（p值>0.05）。比较两组的术中失血量，发现A组的平均失血量（164.03±42.99毫升）明显低于B组（215.83±39.397毫升）（p值<0.05）。
本研究表明，患有鼻息肉的个体在接受功能性鼻内镜鼻窦手术后，术前使用类固醇可成功降低围手术期发病率，特别是术中出血。
