| 摘要: |
| 目的研究利多卡因/肾上腺素表面麻醉和全身麻醉2种不同麻醉方式对成人后鼻腔出血内镜探查术中出血点发现率的影响。方法根据患者意愿及病情情况将164例后鼻腔出血患者分为表面麻醉组118例和全身麻醉组46例，分别在利多卡因/肾上腺素表面麻醉（1%利多卡因+0.01%肾上腺素配比液10ml，用棉片收缩鼻腔黏膜及表面麻醉），或全身麻醉（在全麻基础上使用0.01%肾上腺素配比液10ml，用棉片收缩鼻腔黏膜）下施行内镜探查止血术。观察2种麻醉方式在出血点发现率、术后鼻腔填塞情况以及单次手术治愈率方面的差异。结果表面麻醉组术中发现确切出血点80例，术后鼻腔填塞16例，单次手术治愈102例；全身麻醉组术中发现确切出血点22例，术后鼻腔填塞17例，单次手术治愈36例。表面麻醉组术中出血点的发现率为67.80%，全身麻醉组为47.83%（P＜0.05）。表面麻醉组术后鼻腔填塞比例为13.56%，全身麻醉组为36.96%（P＜0.05）。结论在鼻内镜探查止血术中，利多卡因/肾上腺素表面麻醉下探查鼻腔出血点的成功率显著高于全身麻醉，有利于降低术后鼻腔填塞率，促进患者康复。 |
| 关键词: 鼻出血 麻醉方式 出血点 鼻内镜 疗效 |
| DOI：10.12056/j.issn.1006-2785.2017.39.9.2016-1851 |
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| Influence of different anesthesia methods on endoscopic exploration of posterior epistaxis in adult patients |
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ZHENG Bin, SU Lizhong, LIANG Jing
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Zhejiang provincial People's Hospital
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| Abstract: |
| Objective To study the effect of lidocaine/epinephrine topical anesthesia and general anesthesia on exploration of posterior epistaxis during endoscopic hemostasis in adult patients. Methods One hundred and sixty four patients with posterior nasal bleeding were randomly divided into topical anesthesia group (n=118) and general anesthesia group (n=46). Endoscopic hemostasis was performed under topical anesthesia with lidocaine/epinephrine (10ml of 1% lidocaine+0.01% epinephrine), or under general anesthesia. The detection rate of bleeding points was compared between two groups. Results In the topical anesthesia group, the exact bleeding points were found in 80 cases, while postoperative nasal packing was performed in 16 cases; and 102 cases were cured by single operation. In the general anesthesia group, the exact bleeding points were found in 22 cases, while postoperative nasal packing was performed in 17 cases; and 36 cases were cured by single operation. The rate of exact bleeding point detection in topical anesthesia group was higher than that in general anesthesia group (67.80% vs 47.83%, P=0.018). The postoperative nasal packing rate in topical anesthesia group was lower than that in general anesthesia group (13.56% vs 36.96%, P=0.001). Conclusion The successful rate of probing nasal bleeding under the topical anesthesia is significantly higher than that in general anesthesia during endoscopic exploration and hemostasis for posterior epistaxis in adult patients. It is beneficial to reduce the postoperative nasal packing rate and promote the rehabilitation of patients. |
| Key words: Epistaxis Anesthesia methods Bleeding point Nasal endoscopy Curative effect |
