膨胀海绵与纳米银敷料用于鼻腔填塞的临床观察  

Clinical observation on nasal tamping with expansion sponge and nano silver antibacterial dressing

作　　者：黄朝平[1] 张建辉[1] 彭娟[2] 唐一萍[1] 唐嗣泉[1] 潘庆春[1] 

机构地区：[1]川北医学院附属医院耳鼻咽喉头颈外科,四川南充637000 [2]成都市新都区妇幼保健院妇产科,四川成都610500

出　　处：《中国耳鼻咽喉颅底外科杂志》2013年第1期56-58,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的通过比较鼻内镜术腔两种填塞物的临床效果,为临床选择填塞物提供客观的参考意见。方法选择2010年11月～2012年3月行鼻内镜手术的150例患者,随机分为2组,A组(77例)术后填塞膨胀海绵,B组(73例)术后填塞纳米银敷料,运用视觉模拟量表(VAS),比较两组患者术后鼻腔及头部胀痛程度、抽取填塞物后鼻腔出血情况,以评价两者的临床疗效。结果A组患者术后74.03%有较明显的鼻部及头部胀痛,而B组则为47.95%,两者之间比较差异具有统计学意义(P<0.05);A组患者抽取填塞物后有80.52%出现鼻腔再次出血,而B组患者对应的数据为69.86%,两者之间比较差异无统计学意义(P>0.05)。结论两者的止血效果没有明显差异,膨胀海绵填塞方便,但存在形状固定、膨胀后鼻部及头部胀痛明显等问题,而纳米银抗菌敷料能够根据需要裁剪后进行有针对性的填塞,减少了术后出血的同时具有抗菌、止痛等优点,是鼻内镜术后比较理想的填塞材料。Objective To provide objective advice for clinical selection of tamping material via comparing the effect of two kinds of tamping materials in endoscopic sinus surgery. Methods 150 patients receiving nasal endoscopic surgery in our department from Nov. 2011 to March 2012 were randomly divided into two groups. Expansion sponge was adopted for nasal tamping in group A （ n = 77 ） and AcasinTM dressing in group B （ n = 73 ）. The clinical effect of two kinds of tamping materials was evaluated via comparing the degree of nasal pain or headache using VAS, nasal hemorrhage after extraction of tamping material. Results The incidence rates of nasal pain or headache were 74.03% and 47.95% in group A and B respectively, and the difference was statistically significant （ P 〈0.05）. The incidence rates of nasal hemorrhage were 80.52% and 69.86% in group A and B, withno significant difference （ P 〉 0. 05 ）. Conclusion There is no obvious difference in hemostatic effect between expansion sponge and AcasinTM dressing. Although eonvenient in packing, nasal pain and headache are the disadvantages of expansion sponge. With advantages such as antibacterial activity, pain alleviation and targeted packing, nano silver antibacterial dressing is an ideal tamping material for nasal endoscopic surgery.

关 键 词：鼻内镜 填塞材料 疼痛 出血 

分 类 号：R765.3[医药卫生—耳鼻咽喉科]