摘要
目的:系统评价鼻中隔连续贯穿缝合在鼻中隔成形术中的应用价值。方法:将40例鼻中隔偏曲患者随机分为缝合组和填塞组,每组20例。内镜下行鼻中隔成形术,术终分别予鼻中隔连续缝合或鼻腔填塞处理,比较两组患者术后的鼻部疼痛、头痛、流泪、吞咽困难、睡眠障碍的视觉模拟量表评分(VAS),术前术后的鼻腔黏液纤毛传输时间(MTT)变化,术后出渗血情况。随访2周,观察术后近期并发症。结果:填塞组在术后鼻部疼痛、头痛、流泪、吞咽困难、睡眠障碍的VAS评分均值均大于缝合组(P<0.01);填塞组术前术后的鼻腔MTT变化较缝合组明显延长(P<0.05);术后两组鼻腔出渗血量有明显差异(P<0.05);填塞组术后2周内发现鼻腔粘连1例、鼻腔干燥3例及嗅觉减退2例,缝合组未出现近期并发症。结论:在鼻中隔成形术后采用连续贯穿缝合法代替鼻腔填塞可显著改善患者的术后不适症状,保护鼻腔黏膜清除功能,减少术后近期并发症。
Objective：To systemically evaluate the clinical significance of continuous transfixion suture for nasal septum in septoplasty.Method：Forty patients with nasal septum deviation were randomly assigned to the suture group including 20 patients who underwent endoscopic septoplasty followed by continuous transfixion suture for nasal septum,or the nasal packing group including 20 patients who underwent endoscopic septoplasty followed by nasal packing.Two groups were compared for the visual analogue scale（VAS）scores for postoperative rhinalgia,headache,lacrimation,dysphagia and sleep disorder,changes in mucociliary transport time（MTT）before and after surgery,and postoperative capillary hemorrhage.Patients were followed up for 2 weeks to observe the short-term postoperative complications.Result：Mean VAS scores for rhinalgia,headache,lacrimation,dysphagia and sleep disorder were all higher in nasal packing group than those in suture group（P〈0.05）;compared to suture group,there was greater prolongation of MTT before and after surgery in packing group（P〈0.05）;there was significant difference between two groups in postoperative capillary hemorrhage volume（P〈0.05）;in the nasal packing group,nasal synechia,nasal dryness and hyposmia were observed in 1,3 and 2 patients,respectively,within 2 weeks postoperatively,whereas no short-term complications were observed in the suture group.Conclusion：Use of continuous transfixion suture in place of nasal packing following septoplasty can significantly improve the postoperative symptoms,protect nasal mucociliary clearance,and reduce short-term postoperative complications.
作者
王涵东
宋盼盼
后婕
魏先梅
麻晓峰
陈峰
高下
俞晨杰
WANG Handong;SONG Panpan;HOU Jie;WEI Xianmei;MA Xiao feng;CHEN Feng;GAO Xia;YU Chenjie(Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline （Laboratory）, Research Institution of Otolaryngology, Nanjing, 210008, China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2018年第12期927-930,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
江苏省科教强卫工程江苏省医学重点学科资助(No:ZDXKB2016015)
十三五南京市青年卫生人才培养工程(No:QRX17051)
南京市科委科技发展计划(No:201503015)
