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目的 :探讨鼻内窥镜手术治疗蝶窦病变的麻醉方法和预防眼部并发症的措施。方法 :在 6 5例蝶窦病变的手术治疗中均行局麻加经改进后的表麻 ;术中彻底止血 ,明确碟窦的位置、窦壁吸收与破坏情况 ,以及病变的部位、色泽和形状等特点 ,密切注意眼部症状 ,避免损伤视神经。结果 :随访 0 .5～ 2年。治愈 5 3例 ,复发 7例(其中内翻乳头状瘤 2例 ,慢性蝶窦炎并息肉 5例 ) ,5例失访 ,仅 5例发生眼部并发症。复发病例经再次手术而切除。结论 :在局麻加改进的表麻下能完成蝶窦内窥镜手术 ,熟悉解剖结构及熟练的手术技巧可减少眼部并发症的发生。
Objective: To explore the method of anesthesia for the treatment of sphenoid sinus diseases by nasal endoscopy and the measures to prevent ocular complications. Methods: Twenty-five cases of sphenoid sinus surgery were treated with local anesthesia. The hemostasis during operation was completely stopped. The position of sinuses, the absorption and destruction of the sinus wall and the location, Shape and other characteristics, pay close attention to the symptoms of the eye, to avoid damage to the optic nerve. Results: Follow-up was 0.5 to 2 years. 53 cases were cured, 7 cases relapsed (including 2 inverted papilloma, 5 cases of chronic sphenoid sinusitis and polyp), 5 cases were lost to follow-up, and only 5 cases had ocular complications. Recurrent cases were resected and resected. CONCLUSIONS: It is possible to complete endoscopic sphenoid sinus surgery under local anesthesia with improved anesthesia. Being familiar with anatomical structures and skilled surgical techniques can reduce the incidence of ocular complications.