摘要
目的分析氨甲环酸不同给药方式对功能性内镜鼻窦手术(FESS)的影响。方法选取2020年1月至2021年7月南京市浦口区中医院与南京大学医学院附属鼓楼医院拟行FESS治疗的慢性鼻窦炎患者160例。采用随机数字表法将患者分为静脉注射组、局部用药组、静脉注射+局部用药组、空白对照组,各40例。术中分别采用氨甲环酸不同给药方式预防出血、止血,比较4组患者手术不同时点的平均动脉压、心率及芬太尼使用情况、手术时间、复苏时间、术野出血情况(采用Boezaarts术野评分评估)、实验室指标、术后不良反应发生情况。结果4组患者手术不同时点平均动脉压、心率比较差异均无统计学意义(均P>0.05)。静脉注射+局部用药组患者术中芬太尼用量明显少于静脉注射组、局部用药组及空白对照组(均P<0.05)。静脉注射+局部用药组手术时间明显短于空白对照组(P<0.05)。静脉注射+局部用药组复苏时间明显短于其他3组(均P<0.05)。静脉注射+局部用药组术野评分明显低于其他3组(均P<0.05)。4组患者术前、术后6 h的Hb、红细胞比容、PT、APTT水平比较差异均无统计学意义(均P>0.05)。4组患者均无严重不良反应发生。结论氨甲环酸静脉注射联合局部用药有助于减少FESS术中芬太尼用量,改善手术视野,患者术后恢复时间短,安全性高。
Objective To compare different administration modes of tranexamic acid in functional endoscopic endoscopic surgery(FESS).Methods From January 2020 to July 2021,160 patients with chronic sinusitis scheduled for FESS in Traditional Chinese Medicine Hospital of Pukou District,Nanjing and Drum Tower Hospital Affiliated to Nanjing University School of Medicine were enrolled in the study.Patients were randomly divided into 4 groups with 40 cases in each group:blank control group,intravenous injection group,topical medication group,intravenous injection+topical medication group;the different administration methods of tranexamic acid administration were used to prevent and stop bleeding.The mean arterial pressure,heart rate,use of fentanyl,operation time,resuscitation time,bleeding in the operation field(assessed by Boezaarts operation field score),laboratory indicators,and postoperative adverse reactions were compared among the 4 groups.Results There were no significant differences in mean arterial pressure and heart rate among the 4 groups at different time points during surgery(all P>0.05).The intraoperative fentanyl dosage in the intravenous injection+topical medication group was significantly lower than that in the intravenous injection group,topical medication group and blank control group(all P<0.05).The operation time of intravenous injection+topical medication group was significantly shorter than that of blank control group(P<0.05).The recovery time in the intravenous injection+topical medication group was significantly shorter than that in the other three groups(all P<0.05).The Boezaarts operation field score of the intravenous injection+topical drug group was significantly lower than that of the other three groups(all P<0.05).There were no significant differences in the levels of Hb,hematocrit(HCT),PT,and APTT among the 4 groups before and 6h after surgery(all P>0.05).No serious adverse reactions occurred in the 4 groups of patients.Conclusion Intravenous injection plus topical medication of tranexamic acid can reduce the amount of fentanyl during FESS surgery,improve the surgical field,and shorten the postoperative recovery time with high safety in patients undergoing functional endoscopic sinus surgery.
作者
乔欣伟
孙立保
王涵东
QIAO Xinwei;SUN Libao;WANG Handong(Department of Otolaryngology,Traditional Chinese Medicine Hospital of Pukou District,Nanjing 211800,China;不详)
出处
《浙江医学》
CAS
2022年第7期748-752,755,共6页
Zhejiang Medical Journal
关键词
氨甲环酸
给药方式
功能性内镜鼻窦手术
术野质量
Tranexamic acid
Administration method
Functional endoscopic sinus surgery
Surgical field quality
作者简介
通信作者:乔欣伟,E-mail:n1998248@sina.com。
