慢性鼻-鼻窦炎在内镜手术后不填塞的可行性研究和适应证探讨  

The application,observation and discussion of indications about no packing after ESS

作　　者：樊韵平[1] 陈舒琳[2] 王静清[2] 史剑波[1] 许庚[1] 

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院耳鼻咽喉科中山大学耳鼻咽喉科研究所,广州519000 [2]中山大学附属第五医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2007年第2期61-62,66,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广东省医学科研基金资助项目(No:A2000636)

摘　　要：目的：探讨功能性内镜鼻窦手术（FESS）后不做填塞的安全性和可行性，并对适应证进行研究。方法：对74例慢性鼻窦炎患者（不填塞组）在FESS术后不进行填塞（保障措施包括：适当的病例选择，术前和术后抗炎，止血药物治疗，术中减少损伤，术后细致的防粘连处理），并与填塞组（20例）进行对比分析。结果：不填塞组在FESS术后均无严重出血发生，术后渗血在2～6h内基本停止；在3个月的随访期内无术腔严重粘连发生。结论：采取适当的处理和预防措施，大多数FESS术后患者可不进行填塞，这可明显减轻患者的术后痛苦，降低治疗成本，也使患者对FESS治疗的依从性增加。Objective：To study the safety and feasibility after functional Endoscopic surgery（FESS）, without no nasal packing in 74 patients,compare these patients with 20 packing patients, and discuss the possibility and indication of avoiding packing. Method： No nasal packing after FESS in 74 patients, the measures had been taken to reduce postoperative bleeding including appropriate case-chosen, medical administration before and after operation, alleviation of trauma in operation, and meticulous sinus clearance to prevent synechia. Result： The postoperative blood loss were less than 50 ml. No bleeding complication happened out of the 74 no-packing patients, the blood exudation ceased timely after FESS. Conclusion： The nasal packing could be avoided in the majority of FESS through proper management. This choice will reduce the discomfort and the cost of the patients who have to receive FESS procedure, and increase their compliance.

关 键 词：鼻窦炎 内镜术 

分 类 号：R765[医药卫生—耳鼻咽喉科]