鼻内镜手术中应用控制性粘连技术预防中鼻甲漂移  

Value of controlled synechiae technique on maintaining stability of middle turbinate in endoscopy surgery

作　　者：蒋桃根[1] 晁杰伟[1] 王永田[1] 黄新妍[1] 施丽华[1] 彭芳玲[1] 

机构地区：[1]上海市杨浦区市东医院耳鼻咽喉科,上海200438

出　　处：《临床耳鼻咽喉头颈外科杂志》2012年第21期987-989,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨鼻内镜手术中控制性粘连技术对预防中鼻甲漂移的作用。方法:86例慢性鼻-鼻窦炎患者,在鼻内镜手术过程中判断其中鼻甲有向外漂移倾向,随机分为对照组43例(68侧)和治疗组43例(74侧)。对照组患者延长中鼻道内填塞时间至术后1周,治疗组患者用下鼻甲切吸刀在中鼻甲前下部的内侧面和与中鼻甲切口相对的鼻中隔黏膜各作一2mm×3mm大小切口,再在中鼻道填塞48h。结果:对照组中鼻甲与鼻腔外侧壁发生粘连20侧(29.4%),治疗组中鼻甲与鼻腔外侧壁发生粘连11侧(14.9%),2组比较差异有统计学意义(P<0.05)。对照组16例(24侧)患者嗅觉有不同程度提高,治疗组13例(16侧)患者嗅觉有不同程度提高,2组无一例出现嗅觉下降,2组嗅觉提高率比较差异无统计学意义(P>0.05)。治疗组2例患者出现鼻睫神经痛,经松解中鼻甲与鼻中隔间的粘连带后疼痛症状消失,对照组患者无类似症状。结论:对于因中鼻甲解剖变异或因手术而致支持结构不全或破坏的患者来说,控制性粘连技术能有效防止鼻内镜手术后中鼻甲向外漂移。To explore the method of the controlled synechiae technique to maintain the stability of middle turbinate（MT）, reduce the incidence of middle meatus synechia formation and improve the treatment effect of endoscopy surgery. Method：Eighty-six patients with chronic sinusitits were randomly divided into control group and treatment group in this study. In control group, the patients received extended nasal packing in middle meatus until 1 week after surgery. In treatment group, the patients received the controlled synechiae technique. Result： The MT position was described as stable, slight drifting laterally and synechia formation. And the incidence of synechia between MT and the nasal lateral wall was 29.4% and 14.9% in control group and treatment group,respectively. The differences were significant（P〈0.05）. Conclusion：For those patients with anatomic variation, destruction or weak supporting structures resulted from previous surgery,the controlled synechiae technique is very useful in preventing lateralization of the middle turbinate after endoscopy surgery.

关 键 词：鼻窦炎 内镜术 外科手术 鼻甲 并发症 

分 类 号：R765[医药卫生—耳鼻咽喉科]