鼻腔填塞法和缝合法及负压法在鼻中隔矫正术后应用的效果观察  

Efficacy of nasal packing,septal suture technique and vacuum sealing drainage after nasal septum surgery

作　　者：代保强[1] 刘卫卫[1] 金爱燕 江雪[1] 冯丽春[1] 

机构地区：[1]沧州市中心医院耳鼻咽喉一头颈外科,河北沧州061001

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第2期118-121,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:评价鼻腔填塞法、缝合法和负压引流技术在鼻中隔偏曲矫正术后应用的疗效。方法:选取接受鼻中隔偏曲矫正术和双下鼻甲骨折外移术患者90例,平均分成3组。填塞组:术后以高分子止血海绵填塞鼻腔;缝合组:术后以可吸收缝线缝合鼻中隔黏膜;负压组:术后鼻腔放置负压引流管。对比观察舒适度评分(采用视觉模拟评分法)、术后鼻腔黏膜水肿程度和鼻中隔血肿、脓肿、粘连、术后治愈率等临床指标。结果:术后12、24h内,疼痛视觉模拟评分法读数、鼻塞视觉模拟评分法读数和病情严重程度比较,缝合组和负压组均优于填塞组(P<0.05);术后3d鼻腔黏膜评分比较,缝合组和负压组均明显优于填塞组(P<0.05);术后1周治愈率,缝合组和负压组均明显优于填塞组(P<0.05),术后7d治愈率和并发症发生例数,缝合组和负压组均明显少于填塞组(P>0.05),负压组未出现鼻中隔脓肿、血肿病例。结论:鼻中隔偏曲矫正术后,缝合法和负压法均较填塞法能减轻患者痛苦,缩短术后黏膜恢复时间,不增加术后并发症的发生机率。Objective： The objective of this study was to evaluate the effect of nasal packing, septal suture technique and vacuum sealing drainage（VSD） after septoplasty. Method：Ninety patients of nasal septal deviation in combination with outfracture of the inferior turbinates who had received septoplasty were selected in this study. The patients were allocated into three groups, with thirty in each： for packing group, mercel materials were used for nasal packing after septoplasty~ for suturing group, septal suture technique was performed after septoplasty; for VSD group, one drainage tube was used for negative pressure sucking after septoplasty without nasal packing. Postoperative signs and symptoms were compared between three groups. The comfort degree assessment included headache and nasal obstruction were evaluated by using visual analogue scale（VAS） at the 12th hour and 24 hour after operation. The edema in nasal cavity, hemorrhage, abscess, adhesive and healing rates after operation were compared among three groups. Result：The VAS score of headache and nasal obstruction and the severity of patient＇ s conditions were significantly less in septa[ suture group and VSD group than that in packing group at the 12th and 24th hour after operation. The mucosa edema of nasal cavity was significantly slighter in septal suture group and VS1D group than that in packing group at the third day after operation. The healing rates and number of com- plications are better in septal suture group and VSD group than those in packing group at the 7th day after opera- tion. There were no hemorrhage or abscess in VSI3 group. Conclusion： Septal suture technique and VSD after sep- toplasty can significantly relieve the distress of patients and reduce the healing time of mucosa in nasal cavity with- out increasing the risk of complications.

关 键 词：鼻中隔 鼻腔填塞 鼻中隔缝合 负压引流 疗效 

分 类 号：R765.31[医药卫生—耳鼻咽喉科]