现今，尽管麻醉药物和麻醉技术有了很大进步，但是，全身麻醉术后恶心呕吐（postoperative nausea and vomiting ，PONV）仍然是外科手术后最常见的并发症，其发生率为20％～30％；而在鼻内镜手术中因其手术方式、麻醉用药及麻醉方法等影响导致术后恶心、呕吐发生率相对高一些，有报道发生率可高达46％［1］。其中大部分的患者发生在术后的当天，尤其是麻醉苏醒后的2h以内更为多见。鼻内镜全身麻醉术后发生呕吐不仅让患者遭受痛苦，延迟手术后患者的恢复情况，而且影响患者术后进食、伤口愈合、甚至可造成威胁生命等严重并发症，因此在鼻内镜术后有效预防降低恶心、呕吐发生是临床护士应该关注的问题。本文通过对2013年1月至2015年7月期间我科对532例鼻内镜手术患者实施有效治疗和护理干预；实施期间进行统计分析。通过有效的预防干预和适当的药物治疗，加强正确合理的护理使鼻内镜全身麻醉术后恶心、呕吐的发生率及呕吐程度，较实施前有很大程度的降低。

顽固性鼻出血是耳鼻喉科较严重的也是治疗非常棘手的急症之一。一般治疗是根据出血部位不同采取前后鼻孔填塞、射频治疗、局部微波烧灼，但对于严重的顽固性鼻出血的治疗效果欠佳，因此，介入栓塞技术被广泛应用于顽固性鼻出血的治疗［1］，我科在2008年2月至2015年2月收治的顽固性鼻出血57例行介入栓塞治疗，通过采取系统性护理干预，提高了治疗效果，减轻了患者的痛苦，改善了患者的生活质量。现将护理体会总结报告如下。

The utility model discloses a thyroid gland drag hook of using among tracheotomy, including the connecting rod, and integrative making in the head and the handle at connecting rod both ends, still include and be close to handle one end, and go out the optical cavity on setting up the connecting rod, and be close to head one end, and set up light source chamber on the connecting rod, and set up in the illuminator of light source intracavity side, and connect the intervalve of light source chamber and play optical cavity, illuminator comprises LED pipe, drive circuit and button cell, button cell passes through drive circuit and connects the LED pipe, the LED pipe is just to the intervalve, it comprises non - transparent material to go out optical cavity, intervalve and light source chamber. The utility model discloses a thyroid gland drag hook of using among tracheotomy can guarantee to shine well operation position, and it is simultaneously wild fully to expose the art, and better illumination operation position makes art person easily recognize the operation position, and it is more accurate operate, improves operation efficiency, and it is direct leading -in to the head to avoid illuminator to distribute the heat simultaneously, the improvement nature of performing the operation successfully.

Objective To assess the therapy effect of long-term low-dose clarithromycin joint nasal steroid in the treatment of chro-nic rhino sinusitis. Methods Totally 112 patients with chronic rhino sinusitis who were treated in our hospital from February 2010 to Au-gust 2012 were selected and randomly divided into the treatment group(65) and the control group(47). The patients in the control group were treated by the long-term low-dose clarithromycin joint nasal steroid and nasal irrigation,while the patients in the treatment group were treated by the nasal steroid and nasal irrigation. Then the visual analogue scale, Lund Mackay and the therapeutic effect were evalua-ted. SPSS 16. 0 software was used to analyze the data. Results The Results were as follws:(1) The visual analogue scale score of rhi-nobyon, nasal mucus, headache and hyposmia in the treatment group significantly decreased(P < 0. 05),while only the visual analogue scale score of rhinobyon in the control group significantly decreased(P < 0. 05). (2) The total effective rate in the treatment group (80%) was significantly higher than the control group (51%). The difference was statistically significant(P < 0. 05). (3)About the Lund-Mackey sinus CT score, the treatment group was significantly lower than the control group,and the difference was also statistically significant( P < 0. 05). Conclusion The long-term low-dose clarithromycin joint nasal steroid is superior to nasal steroid in the total effective rate in treatments of patients with chronic rhino sinusitis. It had convenient economic costs and low incidence of adverse reactions. Therefore it has great value for chronic nasal-sinusitis therapy. We recommend it as a first-line drug combination.

The utility model relates to an upper jaw antrum puncture needle, it includes outer needle and interior needle, outer needle includes the needle cover and connects in the needle tubing of needle cover one end, the inside of needle cover is had a perfect understanding and is equipped with the perforation, and the spacing groove has been offered to its entrance point one side, interior needle matches the inside of wearing to locate outer needle, and it includes needle handle and needle body, the needle handle one end outside is protruding be equipped with with the spacing post of spacing groove assorted, the needle handle penetrates in the perforation of needle cover and is spacing through the cooperation of spacing post and spacing groove, the needle body is solid needle body structure, and it matches the tube hole of wearing to locate needle tubing needle point interior and needle point and needle tubing and keeps the parallel and level, the needle body is equipped with miniature position sensor in still in point portion, and miniature position sensor and external computer are through electric signal connection. The utility model has advantages of simple and reasonable structure design, simple to use, convenient and safety can real-time supervision pjncture needle walking orbit, and the medical personnel of being convenient for know the puncture, have improved puncture efficiency.

本研究对我院2009年1月至2014年1月经腹部超声（TAS）和阴道超声（TVS）诊断的子宫腺肌症68例的超声图像特点，旨在探讨T V S诊断子宫腺肌病的临床价值。

耳鸣是没有外界刺激条件下患者闻及异常声音的主观感觉，特别是发展到持续性耳鸣时，可使患者产生不安、忧虑、抑郁等心理，严重影响日常生活和工作。耳鸣掩蔽疗法是通过对耳鸣性质的系统测试后，选择与耳鸣音调响度相匹配的特定外界声作为掩蔽声，在医护的指导下聆听掩蔽声以达到抑制耳鸣或缓解耳鸣症状的方法。我科于2011年9月至2014年9月，根据耳鸣诊断标准，收治耳鸣患者85例(129耳)。用 LS-Ⅲ型耳鸣康复仪治疗耳鸣的患者43例(65耳)，治疗情况报告如下。

儿童食管异物为耳鼻咽喉头颈外科常见急诊之一，其好发于5岁以下儿童［1］。临床表现为哭闹、吞咽困难、流涎、拒食或呕吐等，较大异物若压迫气管，患儿还有发生呼吸困难甚至窒息可能，如诊疗不及时可能引发多种并发症甚至危及生命可能。以往接诊食管异物患儿时，首先均考虑行全身麻醉下硬质食管镜下食管异物取出术，因手术器械质地硬，管径粗加上异物边缘的摩擦作用，术后患儿牙齿磨损、口咽部及食管黏膜损伤常见，食管炎、食管穿孔等发生概率较大，术中手术器械压迫气管，要求行气管插管全身麻醉，由此增加患者术后气道不良反应，术前准备繁琐，治疗费用高，术后住院时间长，患儿痛苦大。本研究主要讨论 Foley管［2］（下称F管）在外形扁平、圆钝光滑类异物取出术中的应用。

出现了鼓膜内陷，应当对症治疗。只要听力基本正常，轻度的鼓膜内陷并不是什么毛病，如果有咽鼓管阻塞或狭窄，以致鼓室和外界气压不能保持平衡，不但有鼓膜内陷，而且听力有所降低，伴有耳鸣、耳闷，这就是病态了，医学上称为慢性非化脓性中耳炎。它虽不像化脓性中耳炎那样流脓或流水，但耳聋、耳闷、耳鸣等症状令人很苦闷。引起咽鼓管阻塞的原因很多，如肥厚性鼻炎、下鼻甲后端肥大、增殖体肥大、鼻咽部肿瘤等，都可以压迫咽鼓管口，引起咽鼓管障碍，使鼓膜内外压力失衡，本文排除了这些病变。选择的都是咽鼓管原因造成的鼓膜内陷，因此保持咽鼓管通畅，是防止鼓膜内陷的关键。我科2010～2012年共收治139例，随机分为两组，在药物治疗的基础上加用导管吹张或速效鼓膜仪辅助治疗。咽鼓管吹张法辅助治疗鼓膜内陷69例，共100耳(其中31例为双耳)；鼓膜按摩辅助治疗鼓膜内陷70例，共102耳(其中32例为双耳)；均有疗效和不同效果，现报告如下。

<正>临床上因各种原因所致的鼻外伤瘘见不鲜。鼻部软骨部塌陷易引起鼻腔粘连,术后换药及支撑软骨部塌陷的愈合已成为临床棘手的问题。鼻部软骨部塌陷不仅影响通气,还影响面部的形象。我科经反复试用一次性吸引管外套作支架治疗鼻部塌陷,于2010年3月至2012年3月共治疗5例,均取得满意效果。

<正>分泌性中耳炎是以鼓室积液及听力下降为主要特征的中耳非化脓性疾病。冬春季节多发,是常见的致聋原因之一。为探讨鼓膜穿刺注药配合He-Ne激光理疗对分泌性中耳炎转归的影响,我们对2006年12月至2009年12月诊治的136例分泌性中耳炎患者的资料进行分析,现报告如

目的 评价鼻内镜手术术毕口服右旋布洛芬对患者术后镇痛的有效性.方法 择期局麻下行鼻内镜手术患者90例,随机分成右旋布洛芬组(治疗组)和对照组,治疗组45例为术毕口服右旋布洛芬2片,之后根据疼痛情况再服1～2次;对照组45例术后不给镇痛药,记录术后不同时点患者的疼痛程度和48h患者对疼痛的总体印象以及不良反应.结果 术后前10h疼痛程度治疗组各时点VSA评分明显低于对照组(P＜0.05).48h内对疼痛的总体印象治疗组轻于对照组.结论 口服右旋布洛芬用于鼻内镜术后镇痛简便、安全、经济、有效.

<正>我院2008年9月至2010年9月开始应用低温等离子手术系统进行扁桃体、腺样体肥大切除手术。通过与传统手术的对比,证明这种手术方法术中出血少,解决了儿童扁桃体、腺样体手术出血量大的难题,手术安全可靠疗效确切,术后疼痛轻。现报告如下。1资料和方法

<正>鼻甲肥大是鼻部常见的疾病之一,症状可有头痛、头昏、失眠,精神萎靡,由于经常张口呼吸,以及鼻腔分泌物的长期刺激,易引起慢性咽喉炎[1]。其危害可使睡眠时有鼾声、甚至呼吸受阻,导致机体缺氧、血氧饱和度下降[2],严重者可影响到正常生活和工作。

<正>Hunt综合征又名耳带状疱疹和膝状神经节炎,是由水痘-带状疱疹病毒感染引起的以侵犯面神经为主的疾病,因Hunt首先描述了该病的临床症状而命名。常见症状为耳部灼痛,起疱疹,面瘫,听力减退及眩晕、耳鸣等。如治疗

<正>变应性鼻炎是一种以鼻黏膜病变为主的Ⅰ型变态反应性疾病,其发病机制十分复杂。变应性鼻炎分为常年性变应性鼻炎(PAR)和季节性变应性鼻炎(SAR)。以往,皮质

临床很多医院大都采用传统的手术铺巾法,即上、下、左、右4块手术巾交错,交错处用扣钳扣紧,暴露手术野.由于鼻、咽喉手术大部分是在局部浸润麻醉或神经阻滞麻醉下进行,患者意识清楚,多取半坐卧位,术中可能有术区移动现象,使手术巾下滑,导致手术野改变,影响手术.我科自制一种斗篷状洞巾,在鼻咽喉手术中应用1 000余例,效果满意,现介绍如下.

<正>我科自2005年5月至2010年10月共收治耳带状疱疹45例,现将护理干预总结介绍如下。1资料与方法1.1临床资料:本组45例,男性26例,女性19例;年龄20~67岁,平均46岁;均为单侧发病,右侧28例,左侧17例;

目的:观察颈部封闭结合药物及心理暗示治疗咽异感症的疗效.方法:对98例咽异感患者行颈部封闭联合药物及心理暗示治疗.结果:治疗一次47例痊愈,35例症状明显好转,16例症状有所好转.结论:颈部封闭和积极有效的心理暗示是非器质性咽异感症治疗成功的关键.

变应性鼻炎是一种以鼻黏膜病变为主的Ⅰ型变态反应性疾病,其发病机制十分复杂.变应性鼻炎分为常年性变应性鼻炎(PAR)和季节性变应性鼻炎(SAR).以前.皮质类固醇和抗组胺药是治疗变应性鼻炎的一线药物,但在临床上有许多合并鼻中隔偏曲或下鼻甲肥大的PAR患者,即使接受正规系统的药物治疗,症状控制也不明显.