摘要
目的:探讨一种新的鼻中隔偏曲矫正术后处理方法——负压引流的可行性,观察与鼻腔填塞法相比是否存在优势。方法:通过前瞻性病例-对照研究将拟行鼻中隔偏曲矫正术的60例患者随机分为鼻腔填塞组和鼻中隔负压引流组,比较2组患者术后24h及48h在伤口疼痛、口干、睡眠障碍、结膜充血、术后局部换药操作时的不适感及出血情况的VAS评分,并于术后1、6周随诊,了解发生再次出血、鼻中隔穿孔、粘连、局部感染等情况的差异。结果:在术后24、48h伤口疼痛、口干、睡眠障碍、结膜充血、术后取纱条或拔出引流管时的不适感及出血情况6个方面,鼻腔填塞组的VAS评分均大于鼻中隔负压引流组(均P<0.05);尤其在48h换药时,鼻腔填塞组的出血量[(21.03±5.88)ml]大于负压引流组[(0.52±0.63)ml](P<0.01)。术后1、6周随访,2组间疼痛或并发症等数据比较差异无统计学意义(P>0.05)。结论:鼻中隔偏曲矫正术使用鼻中隔负压引流切实可行,与鼻腔填塞相比,能明显减轻患者的痛苦,且不增加术后并发症发生的概率,值得推广和应用。
Objective：To study whether negative-pressure septal drainage could be an alternative to packs after septoplasty.Method：This was a randomized controlled trial.The study involved 60 patients who underwent septoplasty.Patients were randomly divided into two groups,one with anterior nasal packs and the other with negativepressure septal drainage.Patients were asked to record pain levels using a visual analogue scale（VAS）.Postoperative symptoms and complications were compared during 24 hand 48hpostoperative period including pain,drying sensation of mouth,sleep difficulty,conjunctival congestion,haemorrhage.VAS scores and incidence were evaluated during 1 week and 6 weeks postoperative period including pain,bleeding,haematoma,septal perforation,synechiae and septal perforation.Result：Patients of negative-pressure septal drainage suffered from less pain than patients of nasal packs during the first 24 hand 48hpostoperative period.The results for pain,drying sensation of mouth,sleep difficulty,conjunctival congestion,haemorrhage were different between groups（P0.05）,especially the amount of bleeding during 48 h postoperatively in patients undergoing negative pressure drainage[（0.52±0.63）ml]was significantly less than the group who received anterior nasal packs [（21.03±5.88）ml]（P0.01）.On the other hand,haematoma,synechiae and perforation were not statistically different between groups during 1week and 6weeks follow-up period（P 0.05）.Conclusion：Using negative-pressure drainage instead of nasal packs after septoplasty seems a more reasonable option.The negative-pressure drainage technique may be the preferred option to provide higher patient satisfaction and has the same level of postoperative complication to nasal packs as for septoplasty surgery.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2015年第5期448-451,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
