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降低底内注射出血:一个系统的审查和元分析
Sung Ryul Shim1,2, Jieun Shin1,2, Cheol Mog Hwang3
1Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea.
JAMA otolaryngology-- head & neck surgery
|February 13, 2025
概括
用利多卡因和上腺素注射到皮下垂体,可以在内镜外科手术 (ESS) 期间改善外科现场可视化. 这种技术有效地减少出血并降低平均动脉压 (MAP),改善患者的治疗结果.
科学领域:
- 耳鼻喉科和外科创新的创新
- 最少侵入性的鼻外腔手术
背景情况:
- 内镜外科手术 (ESS) 是治疗鼻疾病的主要治疗方法.
- 在ESS期间,手术内出血是一个重大挑战,可能会危及手术结果和患者安全.
研究的目的:
- 系统地评估ESS期间使用利多卡因和上腺素的pterygopalatal注射的疗效.
- 评估这些注射对外科领域质量和手术内出血的影响.
主要方法:
- 我们对PubMed/MEDLINE,Cochrane图书馆和EMBASE进行了系统的文献搜索.
- 包括随机的临床试验比较了pterygopalatal注射 (利多卡因/上腺素) 与盐水或没有注射.
- 结果包括主观的外科领域分级 (Boezaart外科领域分级 (BSFG)) 和客观的措施,如出血量和平均动脉压 (MAP).
主要成果:
- 对7项涉及322名患者的研究分析显示,BSFG显著改善 (SMD = -1.01),表明更好的外科领域.
- 观察到MAP的显著减少 (MD = -0.49 mm Hg).
- 在出血量 (MD = -9.47 mL) 或手术持续时间 (MD = -4.28 分钟) 中没有发现显著差异.
结论:
- 用利多卡因和上腺素的Pterygopalatal注射在ESS期间有效改善外科现场可视化.
- 该技术有助于提高外科实地质量和减少MAP,可能提高手术安全性和疗效.
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