慢性鼻-鼻窦炎鼻息肉内镜手术严重并发症分析.doc

慢性鼻-鼻窦炎鼻息肉内镜手术严重并发症分析 2007年1月第42卷第1期ChinJOtorhinolaryngolHeadNeckSurg,January2007,Vol42,No.1 慢性鼻一鼻窦炎鼻息肉内镜手术 严重并发症分析 时光刚李秀国王昭迪 ? l9? . 鼻内镜外科. 【摘要】目的探讨慢性鼻-鼻窦炎鼻息肉内镜手术严重并发症的分类,发生率及其影响因素, 以期从中获得启示.方法对随访资料完整的1102例(1769侧)慢性鼻一鼻窦炎鼻息肉患者内镜手 术发生2l例次严重并发症的情况进行总结,分析.结果2l例次严重并发症包括:眶内血肿3例 次,眼内直肌损伤2例次,视力丧失1例次,颅内血肿1例次,脑脊液鼻漏3例次,鼻泪管阻塞3例次, 鼻中隔穿孔2例次,大出血2例次,下肢血栓形成2例次,术后哮喘发作2例次.严重并发症的发生 率为1.91%(21/1102),其中眼部并发症(0.54%)和颅内并发症(0.36%)发生率较高.患者的病变 范围,前期手术史和术者的手术经验及技巧是影响严重并发症发生率的重要因素.结论导致鼻内 镜手术严重并发症的因素众多,然而主观因素比客观因素起更大的影响作用,其中以术者的手术经验 尤为重要. 【关键词】鼻窦炎;鼻息肉;内窥镜检查;并发症 Severecomplicationsinthetreatmentofchronicrhinosinusitisandnasalpolypswithendoscopicsinus surgerysHlGuang-gang,LIXiu-guo,WANGZhao—aDepartmentofOtorhinolaryngology. ShandongProvincialHospitalamp;ShandongUniversity,Jinan250021,China. Correspondingauthor:SHIGuang-g鲫g,Email7o36285@163.com 【Abstract】ObjectiveToinvestigatetheclassification,incidenceandinfluentialfactorsofsevere complicationsoccultedinendoscopicsinussurgery(ESS)andhowtodealwiththem.Methods0Be tIIousandandonehundredtwopatientswithchronicsinusitisandnasalpolypstreatedbyESSwereanalyzed. ResultsTwenty-onepatientshadseverecomplications.Thetypesofcomplicationincludedintraorbital hematoma(n=3),medialrectusinjury(n=2),blindness(n=1),intracranial,hematoma(n=1), cerebrospinalrhinorrhea(n=3),nasolacrimalductinjury(n=3),nasalseptumperfoation(n=2), hemorrhage(n=2),thrombosisinlegs(n=2)andasthma(n=2).Thetotalincidenceofsevere complicationsWas1.9l%(21/1102),mostofwhichwerecomplicationsinorbit(0.54%)andcraniam (0.36%).Theextentofthelesion,thesurgicalhistoryofthepatients,thetechniqueandexperienceofthe surgeonsweretIIemostimportantinfluentialfactorstoseverecomplications.ConclusionsA1thoughthere aremanyinfluentialfactorstoseverecomplicationsinESS,subjectivefactorsalethemoreimportant. especialy,thetechniqueandtheexperienceofthesurgeon. 【Keywords】Sinusitis;NasalPolyps;Endoscopic;Postoperativecomplications 鼻内镜手术已经成为治疗慢性鼻一鼻窦炎鼻息 }- 肉(chronicrhinosinusitiswithnasalpolypsis. CRSwNP)的最主要治疗手段,但是,鼻内镜手术并 发症