Analysis the status and risk factors of nasal bleeding after endoscopic transsphenoidal resection in patients with pituitary adenomas / 中国实用护理杂志

ABSTRACT

Objective:To understand the status of nasal bleeding after endoscopic transsphenoidal resection in patients with pituitary adenomas and to explore its risk factors.Methods:By using the convenience sample way, a total of 413 patients in pituitary adenomas who were admitted to the endoscopic transsphenoidal resection from the Second Affiliated Hospital of Zhejiang University School of Medicine were selected as study objects from June, 2018 to December, 2019. The status questionnaire and factors questionnaire of nasal bleeding after endoscopic transsphenoidal resection in patients with pituitary adenomas was used to measure the status and factors of nasal bleeding. The risk factors were analyzed by single factor analysis andlogistic regression analysis.Results:There were 38 patients with nasal bleeding after endoscopic transsphenoidal resection in patients with pituitary adenomas, with a incidence rate of 9.2%. Among them, 25 patients (65.8%) had precipitating factors of nasal bleeding, mainly sneezing and coughing (11 cases) and constipation (9 cases), and the bleeding season were mainly winter (13 cases) and autumn (14 cases), the average time of postoperative nasal bleeding occurred on the 13th day. The single factor analysis indicated that nasal bleeding related to hyperlipidemia, smoking, anticoagulants, constipation, intraoperative sphenoid artery injury, surgical approach (single and double nostrils), duration of surgery, nasal irrigation, red blood cells, platelets ( P<0.05). The Logistic regression analysis showed that anticoagulants, constipation, intraoperative sphenoid artery injury, nasal irrigation, platelets related to nasal bleeding ( P<0.05). Conclusion:The incidence of nasal bleeding after endoscopic transsphenoidal resection in patients with pituitary adenomas high, and have obvious triggers. The medical staff should focus on preoperative and intraoperative assessment, for the patients had anticoagulant history, constipation, low platelet and possible sphenoid artery and branch injury, should wary the nasal bleeding, nasal irrigation should used to reduce the risk of postoperative nasal bleeding.