可吸收止血材料用于鼻内镜术后填塞效果的观察  

Efficacy of absorbable packing after functional endoscopic sinus surgery

作　　者：孙靖雯[1] 张家雄[1] 蔡晓菁[1] 钱备[1] 魏明[1] 陈萍[1] 赵传亮 邹文焘[1] SUN Jing-wen;ZHANG Jia-xiong;CAI Xiao-jing;QIAN Bei;WEI Ming;CHEN Ping;ZHAO Chuan-liang;ZOU Wen-tao(Department of Otorhinolaryngology,Shanghai 10th People＇s Hospital,Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院上海市第十人民医院耳鼻咽喉科,上海200072

出　　处：《中国眼耳鼻喉科杂志》2018年第4期254-257,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：同济大学青年优秀人才培养计划(1501219113);上海市第十人民医院B类攀登人才(04.01.16.029)

摘　　要：目的研究可吸收止血材料纳吸棉及明胶海绵在鼻内镜术后鼻腔填塞的临床效果。方法对56例因慢性鼻-鼻窦炎(CRS)于我科行功能性鼻内镜鼻窦手术(FESS)的患者进行随访。按术后填塞止血材料的不同分为纳吸棉组及明胶海绵组,比较2组在术前以及术后1 d的鼻部疼痛程度,术后2、4、12周的临床表现,包括鼻塞、流涕、头面部胀痛的视觉模拟评分(VAS)以及鼻内镜Lund-Kennedy评分。结果纳吸棉与明胶海绵都具有有效的止血作用。术后1 d 2组的填塞舒适度以及术后2周VAS、鼻内镜评分差异无统计学意义(P>0.05),术后1个月及3个月2组的VAS及鼻内镜评分差异有统计学意义(P<0.05)。纳吸棉组的鼻塞、流涕症状明显好于明胶海绵组,术腔愈合情况也比明胶海绵组更好,主要表现在息肉、水肿和鼻漏方面,而瘢痕、结痂评分差异无统计学意义。结论纳吸棉与明胶海绵都是有效的鼻腔止血材料,但是纳吸棉更理想。Objective To investigate the effect of Gelfoam and Naso Pore on packing after functional endoscopic sinus surgery（ FESS）. Methods A total of 56 chronic rhinosinusitis（ CRS） patients who had undergone FESS were followed up. In accordance with various nasal packing materials,patients were divided into Naso Pore group and Gelfoam group. Nasal pain was evaluated by visual analogue scale（ VAS） before and 1 day after the operation.Clinical manifestations including VAS regarding nasal obstruction,nasal discharge and headache and Lund-Kennedy scores were evaluated 2,4,12 weeks after the operation. Results Both Naso Pore and Gelfoam had hemostatic effect.There was no significant difference in VAS and Lund-Kennedy scores between the two groups in 2 weeks（ P 〉 0. 05）.Difference of the two groups was significant in 4 and 12 weeks（ P 〈0. 05）. In Naso Pore group,incidence of nasal obstruction and nasal discharge were lower and nasal cavity healing was better than Gelfoam group. Conclusions Both Naso Pore and Gelfoam are effective hemostatic packing materials and Naso Pore is better than Genlfoam.

关 键 词：功能性鼻内镜鼻窦手术 纳吸棉 明胶海绵 可吸收止血材料 鼻腔填塞 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]