- 期刊
鼻竇內視鏡手術的預後及術後照護與治療
Outcomes and Postoperative Care of Endoscopic Sinus Surgery
摘要
鼻竇內視鏡手術問世至今，已成爲慢性鼻及鼻竇炎病患經藥物治療無效後的標準治療方法，鼻竇炎內視鏡手術對於改善病患症狀具有良好效果，改善率約爲70-95%左右，縱使如此、鼻及鼻竇內視鏡手術仍無法完全解決慢性鼻及鼻竇炎病患的困擾。病患體質、手術過程疏忽、及術後追蹤治療不足都是影響手術預後的常見原因，其中術後照護與治療跟手術同等重要。手術醫師於施行鼻竇內視鏡手術的術後照護與治療應具備對鼻竇黏膜生理功能及術後病理變化的知識，同時做到「仔細的檢查」、「積極的清創」、以及「適當且足夠的內科治療」，並教導病息做好日常鼻及鼻竇清潔工作以加速鼻竇傷口的痊癒與鼻竇生理功能的復原。
並列摘要
Endoscopic sinus surgery (ESS) has developed over last 20 to 30 years into a world-wide accepted treatment method for chronic rhinosinusitis in those who have failed maximal medical treatment. Patients' subjective improvement can reach as high as 70-95% after ESS. However, there are some confounders may interfere the outcomes of the surgery, such as patient's constitution, negligence in surgery, and insufficiency in postoperative follow-up and care? Postoperative care and treatment are as important as surgery. To well perform the postoperative care and treatment of ESS, ENT surgeons need to realize the normal physiological functions of rhinosinal mucosa and the pathophysiological changes during postoperative period. Principles of the postoperative care and treatment of ESS are meticulous inspection, aggressive debridement and appropriate medical therapy. To educate patients about the toilet of rhinosinal cavity is contributory to the healing of surgical wound and the restoration of rhinosinal functions.