鼻中隔偏曲矫正术后不同处理方法对患者舒适度的影响  

Influence of different management on postoperative comfort of patients after sub-mucous correction of nasal septum deviation

作　　者：赵素萍[1] 杨仕明[1] 

机构地区：[1]解放军总医院耳鼻咽喉科研究所,耳鼻咽喉头颈外科,北京100853

出　　处：《中国耳鼻咽喉头颈外科》2013年第10期534-536,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：解放军总医院科技创新苗圃基金项目面上项目(12KMM29)

摘　　要：目的比较鼻中隔偏曲矫正术后鼻腔填塞和缝合两种处理方法对患者舒适度的影响。方法 31例鼻中隔偏曲矫正术后患者接受调查,男18例,女13例,平均年龄（31.6±11.2）岁。根据鼻腔处理方式将研究对象分为两组,填塞组20例,缝合组11例。采用疼痛视觉模拟量表（visual analogue scale,VAS）评分进行疼痛评估。使用一条长约10 cm的游标尺,刻度面标有0~10的刻度,请患者标出自己疼痛的级别感受。分值越高,主观疼痛感觉越强烈。总共进行了9个方面的VAS评分。结果缝合组在鼻部疼痛（t=2.152,P=0.040）、头痛（t=4.944,P〈0.001）、疼痛所致流泪（t=4.944,P=0.002）、吞咽困难（t=3.359,P=0.003）、鼻闷胀感（t=3.359,P=0.023）、睡眠时的疼痛感（t=3.225,P=0.004）、生活舒适度（t=3.332,P=0.002）等7个方面的VAS平均得分低于填塞组,出血（t=-0.372,P=0.714）和通气（t=1.522,P=0.144）两个方面的VAS评分在两组间没有统计学意义上的差别。总体VAS评分缝合组显著低于填塞组（P〈0.001）。结论鼻中隔缝合可为患者提供更高的术后舒适度。OBJECTIVE To compare the influence of haemostatic packing and suturing technique on the postoperative comfort of patients in sub-mucous correction of nasal septum.METHODS 31 patients were investigated on their postoperative comfort after sub-mucous correction of nasal septum,including 18 males and 13 females,mean age of which was（31.6±11.2）years.The subjects were divided into 2 groups：suturing group（11 patients）and packing group（20 patients）.The subjects were asked to evaluate their pain intensity induced by the surgery using Visual Analogue Scale for pain（VAS）.The pain VAS is a one-dimensional measures of pain intensity,which has been widely used in diverse adult populations.The pain VAS is self-completed by the respondent.The respondents were asked to place a marker to the VAS ruler at the point that represents their pain intensity.A score between 0 and 10 was determined by the position of the marker on the VAS line.A higher score indicates greater pain intensity.RESULTS VAS scores of suturing group in nasal ache（t=2.152,P=0.040）,headache（t=4.944,P〈0.001）,lachrymation（t =4.944,P =0.002）,swallow difficulty（t=3.359,P=0.003）,snuffle（t=3.359,P=0.023）,sleeping（t=3.225,P=0.004）,and life comfort（t=3.332,P=0.002）were lower statistically than those of packing group.There＇s no significant difference in bleeding（t =-0.372,P=0.714）and ventilation（t=1.522,P =0.144）between groups.Summating VAS scores of suturing group is lower than packing group（P〈0.001）.CONCLUSION Suturing technique in sub-mucous correction of nasal septum surgery can provide more postoperative comfort than haemostatic packing.

关 键 词：疼痛测定 手术后并发症 鼻中隔 鼻中隔成形术 鼻腔填塞 缝合技术 

分 类 号：R765[医药卫生—耳鼻咽喉科]