摘要
目的:对比鼻中隔偏曲矫正术后常规的鼻腔填塞和鼻中隔缝合而不填塞鼻腔2种方法,试图找到一种鼻中隔术后无需鼻腔填塞的方法。方法:将80例行鼻中隔偏曲矫正和下鼻甲部分切除的患者分为填塞组和缝合组,填塞组40例常规行鼻中隔矫正,等离子消融肥大的下鼻甲,最后鼻腔填塞膨胀海绵;缝合组40例在鼻中隔偏曲矫正术后行鼻中隔缝合(参考Wormald的鼻中隔连续缝合方法并进行改良),对肥大的下鼻甲使用等离子射频消融系统进行消融,术后双侧鼻腔无其他填塞物。比较2组患者在术后鼻部疼痛、头疼、流泪、吞咽困难、睡眠困难、出血以及在抽取鼻腔填塞物时的疼痛和出血的VAS评分,术后门诊随访时记录患者有无再次出现出血、鼻中隔穿孔、鼻中隔血肿、粘连、局部感染等情况。结果:在术后鼻部疼痛、头疼、吞咽困难、睡眠困难、出血这5个方面,填塞组的VAS评分均值均大于缝合组(P<0.01),在流泪方面2组差异无统计学意义,而术后填塞组抽取填塞物时的疼痛感及出血量远远大于缝合组清理鼻腔时的疼痛感和出血量(P<0.01),填塞组术后1例出现中隔血肿,而等离子缝合组未出现。结论:鼻中隔缝合使得鼻中隔偏曲矫正术术后不填塞成为可能,患者术后出血少、痛苦极小,也避免了鼻中隔血肿等并发症的出现,鼻中隔术后不一定需要鼻腔填塞。
Objective：Patients undergone septoplasty,which is one of the most common procedures,always feel very painful after surgery because of routine nasal packing.The objective of this study was to evaluate the effect of septal suture technique without nasal packing after septoplasty.Method：Eighty patients who had undergone septoplasty were included in this study.The patients were allocated into tow groups： packing group,mercel was used for nasal packing after septoplasty and inferior turbinate coblation;suturing group,septal suture and infterior turbinate coblation were performed after septoplasty without nasal packing.Postoperative signs and symptoms（visual analogue scale,VAS） were compared between the two groups.Result：The patients of packing group experienced significantly more postoperative nasal pain,headache,dyaphagia,sleep disturbance and bleeding after surgery（P0.01）.No difference of epiphora was found between the two groups.More pain and bleeding were experienced during the pack removal（packing group）,compared to that during the clearance of nasal cavity（suturing group）.One patient with postoperative septal hematoma was found in the packing group.Conclusion：Nasal septum suture combined with inferior turbinate coblation might be a significantly more comfortable,reliable alternative to nasal packing.Nasal packing is not the necessary application for septoplasty.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2011年第23期1068-1070,1075,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻中隔偏曲
缝合技术
鼻腔填塞
deflection of nasal septum
suture techniques
nasal packing
