医用自交联透明质酸钠凝胶在鼻窦炎术后填充中的效果观察  

Medical self-crosslinking sodium hyaluronate gel for packing nasal cavity after surgery for nasosinusitis

作　　者：张建中[1,2] 赵耀新[1] 李静远[1] 胡华勇[1] 蔡刚[1] 赵玉林[2] 

机构地区：[1]广州医科大学附属第五医院耳鼻咽喉头颈外科,510700 [2]郑州大学第一附属医院耳鼻咽喉头颈外科,450052

出　　处：《国际医药卫生导报》2017年第17期2725-2728,共4页International Medicine and Health Guidance News

摘　　要：目的观察在鼻窦功能性手术后使用医用自交联透明质酸钠凝胶行鼻腔填塞后的效果。方法本研究采用自身对照、随机、前瞻性、第三方盲评的方法，选择24例鼻窦炎患者，按Lund—mackay系统评分双侧鼻窦相等，手术由同一医师完成，按随机表决定术腔填塞材料（观察侧选用医用自交联透明质酸钠凝胶填塞，对照侧填充羟甲基纤维素）；填充材料对记录者设盲，记录术后3d患者鼻面部不适程度；1周后开始鼻腔冲洗，出院后1、2、4、8及12周复查，复查时不采用医学干预，分别记录鼻腔鼻窦黏膜形态，行Lund—Kennedy鼻内镜评分，进行统计分析。结果24例鼻窦炎患者，使用医用自交联透明质酸钠凝胶填充侧的不适程度明显低于对照侧；医用自交联透明质酸钠凝胶填充鼻腔鼻窦侧上皮化时间明显缩短，术后1、2、4周鼻内镜下黏膜形态明显优于对照组（P〈0．05），术后8、12周两组比较差异有统计学意义（P〉0．05）。结论医用自交联透明质酸钠凝胶能明显减轻患者术后鼻腔填塞不适感；能促进鼻腔、鼻窦黏膜上皮功能恢复，缩短黏膜上皮化过程，减少术腔水肿、囊泡、痂皮形成及黏膜粘连，更有利于鼻腔鼻窦术后功能恢复。Objective To observe the effect of medical self-crosslinking sodium hyaluronate gel for packing nasal cavity after functional nasal sinus surgery. Methods 24 patients with nasosinusitis whose scores of Lund-Mackay system in bilateral sinuses were equal were selected. All the patients＇ surgeries were completed by the same doctor. Ones of the patients＇ nasal sinuses were packed with medical self-crosslinking sodium hyaluronate gel （set as an observation group） and the ones with carboxy methyl cellulose （set as a control group）, randomly. All the patients had no idea of the packing materials. The patients＇ nasal-facial discomfort was recorded 3 days after the operation. Nasal douche was taken for all the patients 1 week from then. 1, 2, 4, 8, and 12 weeks after discharge, the patients were re-checked without medical intervention and the mucosal morphology of nasal cavity and sinus was recorded and nasal endoscopic scoring was carried out in all the patients. The results were statistically analyzed. Results The discomfort degree was lower, the epithelization time of nasal cavity and sinus was shorter, and the mucosal morphology of nasal cavity and sinus 1, 2, and 4 weeks after the operation were better in the observation group than in the control group （all P〈0.05）. There were no statistical difference in the mucosal morphology of nasal cavity and sinus 8 and 12 weeks after the operatio between these two groups （P〈0.05）. Conclusions Medical self-crosslinking sodium hyaluronate gel can obviously relieve the patients＇ postoperative nasal-cavity-packing discomfort promote the recovery of mucous epithelium function in nasal cavity and sinus, facilitate mucosal epithelialization, and reduce surgical cavity edema, vesica, crust, and mucous membrane adhesion and is good for the functional recovery after nasal cavity and sinus surgery.

关 键 词：透明质酸钠 鼻窦功能性手术 不适 黏膜形态 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]