经鼻中隔黏膜下入路垂体瘤切除术后嗅觉改变的影响因素

目的探讨经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的影响因素及护理对策。方法选取2019年1—12月在医院行经鼻中隔黏膜下入路垂体瘤切除术患者90例作为研究对象,将发生嗅觉改变的13例患者作为改变组,未发生嗅觉改变的77例患者作为正常组。采用单因素分析筛选影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的相关危险因素,对有统计学意义的纳入因素进行多因素Logistic回归分析,确定影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的独立危险因素。结果13例出现嗅觉改变的患者中,9例轻度嗅觉减退,3例中度嗅觉减退,1例重度嗅觉减退。单因素分析结果显示,性别、手术时间、保留中鼻甲、消毒液浓度、鼻窦炎、脑脊液鼻漏、鼻腔粘连及鼻出血是影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的相关因素(P<0.05);多因素Logistic回归分析结果显示,保留中鼻甲、脑脊液鼻漏及鼻窦炎是影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的独立危险因素(P<0.05)。结论保留中鼻甲、鼻窦炎及脑脊液鼻漏是影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的独立危险因素。提示医护人员应针对以上危险因素,制定相应护理对策,尽量避免对患者鼻腔正常生理结构与鼻腔黏膜的损害,加强术后鼻腔护理,减少相关并发症的发生,指导患者坚持,以促进患者术后嗅觉功能的恢复。

Influencing factors of olfactory change on the patients after resection of pituitary adenoma via submucosal approach through nasal septum

Objective To explore the influencing factors of olfactory change on the patients after resection of pituitary adenoma via submucosal approach through nasal septum and the nursing measures.Methods To select 90 patients undertook the resection of pituitary adenoma via submucosal approach through nasal septum in the hospital from January to February 2019 as the study objects,13 patients with the olfactory change were set as the change group and 77 patients without the olfactory change were set as the normal group.Unifactor analysis was applied to identify the influencing factors of the the resection of pituitary adenoma via submucosal approach through nasal septum patients with the olfactory change,applied the multiple Logistic aggression analysis on those statistically significant factors,found out the independent risk factors that effect the resection of pituitary adenoma via submucosal approach through nasal septum patients with the olfactory change.Results Among the 13 patients with olfactory changes,9 cases had the mild hypoosmia,3 cases had the moderate hypoosmia,1 case had the severe hypoosmia.Unifactor analysis result shows that gender,operation time,preserve middle turbinate,disinfection concentration,nasosinusitis,cerebrospinal fluid rhinorrhea,nasal adhesion and epistaxis were the related factors that effect the olfactory change on the patients after resection of pituitary adenoma via submucosal approach through nasal septum(P<0.05).Multivariate Logistic regression analysis showed that,preserve middle turbinate,cerebrospinal fluid rhinorrhea and nasosinusitis were the independent risk factors that effect the olfactory change on the patients after resection of pituitary adenoma via submucosal approach through nasal septum(P<0.05).Conclusion Preserve middle turbinate,cerebrospinal fluid rhinorrhea and nasosinusitis were the independent risk factors that effect the olfactory change in the patients after resection of pituitary adenoma via submucosal approach through nasal septum.The medical staffs should arrange the corresponding nursing measures according to those risk factors,try to avoid the damage to the normal physiological structure of the patients’nasal cavity and nasal mucosa,enhance postoperative nasal care,reduce the occurrence of related complications,guide the patients insist,promote the recovery of the postoperative olfactory function.