硝酸甘油控制性降压对鼻内窥镜手术出血的影响

目的　探讨硝酸甘油控制性降压对内窥镜鼻窦手术术中出血的影响。方法　选择首次鼻中隔偏曲、慢性鼻窦炎、鼻息肉手术的病人 2 0例,年龄在 2 0～ 5 0岁之间,无重要合并症,随机分为对照组和硝酸甘油控制性降压组,每组 10例。术中监测平均动脉压、心率及出血量,记录手术时间并询问手术医生对手术视野满意的程度。结果　两组病人的术中出血量和手术时间比较无显著性差异(P >0 0 5 ),实验组术中心率明显高于术前(P <0 0 1),手术医生对实验组满意或较为满意率为 10 0 %,对照组满意或较为满意为 90 %。结论　硝酸甘油控制性降压运用于内窥镜鼻窦手术对于无合并症的年轻病人效果不显著。

Clinical study on effects of controlled hypotension with Nitroglycerin in bleeding control during sinonasal microsurgery

Objective To investigate how the controlled hypotension with Nitrogly cerin affects the hemorrhage amount of patients,who underwent endoscopic sinus s urgery.Methods Twenty patients who were beween 20 to 50 years old,without any c o mplictations,and operated first time for suffering deviated nasal septum,chronic sinusitis,nosal polypus,were divided into two groups,the control group and t he experimental group (controlled hypotension with Nitroglycerin),each group ha s ten cases.The MAP,HR,CO were monitored,the operation time,the degree of surgeon ' s satisfaction with the operation area view were also recorded.Results The blee d ing amount and the operation time in experimental group are less than those i n control group,but there is no statistical singnificance(P>0.05).HR of experimental group during operation were faster than that before operation,the result i s statistically significant(P<0.01).The rate of surgeon's satisfaction and relati ve satisfaction in the experimental group is 100%,in the control group is 9 0%.Conlusion To the healthy young patients without any complications,applying controlled hypotension with Nitroglycerin conldn't reduce the quantity of bleedi ng during endoscopic sinus surgery and shorten the operation time,it is not an e ffective method.