具有切吸功能的鼻中隔剥离器在鼻中隔成形术中的应用  

Application of nasal septum periosteum elevator with cutting and aspirating function in the modified septoplasty

作　　者：周诗侗 后群 陈知己 安祥 陈红江 高明华 方红雁 ZHOU Shitong;HOU Qun;CHEN Zhiji;AN Xiang;CHEN Hongjiang;GAO Minghua;FANG Hongyan(Department of Otolaryngology Head and Neck Surgery,Chongqing General Hospital,University of Chinese Academy of Sciences,Chongqing,400014,China;Department of Otolaryngology Head and Neck Surgery,the Third People's Hospital of Honghe,Gejiu,Yunnan,661000,China)

机构地区：[1]中国科学院大学重庆医院(重庆市人民医院)耳鼻咽喉头颈外科,重庆400014 [2]红河州第三人民医院耳鼻咽喉头颈外科,云南个旧661000

出　　处：《中国耳鼻咽喉头颈外科》2020年第10期583-585,571,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：重庆市技术创新与应用示范项目(cstc2018jscx-msybX0122);重庆市渝中区基础研究与前沿探索项目(20180138);重庆市人民医院医学科技创新基金重点项目(Y2017ZDXM05)。

摘　　要：目的探讨一种具有切吸功能的鼻中隔剥离器在三线减张鼻中隔成形术中的应用价值。方法将100例需行鼻中隔成形术的鼻中隔偏曲患者分为2组,观察组(50例)使用具有切吸功能的鼻中隔剥离器,对照组(50例)使用常规鼻中隔剥离器及普通吸引管,比较两组的手术时间、出血量、手术单人完成率及术中吸引管堵塞率。随访半年,分析疗效。结果观察组手术时间、出血量及术中吸引管堵塞率均低于对照组,手术单人完成率高于对照组,差异均有统计学意义(P<0.05)。两组术中单侧黏膜破损率比较,差异无统计学意义(P>0.05),两组均无双侧黏膜对穿破损。术后随访半年,两组鼻内镜检查矫正满意率均为100%,均无鼻中隔血肿、鼻中隔摆动、鼻中隔穿孔及鼻背塌陷等并发症。结论使用具有切吸功能的鼻中隔剥离器进行三线减张及楔形切除嵴/棘突矫正鼻中隔偏曲,操作方便、快捷,视野清晰,大部分手术可单人完成,其手术时间短、出血少、创伤小,术后并发症少,值得向基层推广。OBJECTIVE To explore the clinical application of nasal septum periosteum elevator with cutting and aspirating function in the modified septoplasty with three high tension lines resection.METHODS100 patients of deviation of nasal septum were divided into two groups,who underwent the modified septoplasty with personalized three high tension lines resection and wedge resection of spur/ridge.The observation group(50 cases) were received the surgery with a special nasal septum periosteum elevator with cutting and aspirating function while the control group(50 cases) with conventional nasal septum stripper and ordinary suction tube.The operation time,blood loss,the ratio of operation completed by one surgeon and attract tube plugging were compared between the two groups.Followed up for six months,their clinical data were retrospectively analyzed.RESULTS The mean operative time,average blood loss and the rate of attract tube plugging in the observation group were lower than those in the control group(P<0.05),while the ratio of operation completed by one surgeon of the observation group was higher than that in the control group.However,no significant difference of the unilateral nasal septum mucosa damage rate between two groups(P>0.05) and there was no bilateral nasal septum mucosa damage in both groups.The satisfaction rate of correction under endoscopy was 100% and there were no complications such as septal hematoma,septum swing,septum perforation and nasal dorsal collapse in six months after surgery.CONCLUSION The use of the periosteum elevator with cutting and aspirating function for the modified septoplasty with three high tension lines resection and wedge resection of spur/ridge make most of the operations be performed by only one surgeon.With advantages of shorter operative time,less bleeding,clearer vision,less trauma and fewer postoperative complications,it could be applied widely in primary hospital.

关 键 词：内窥镜检查 鼻中隔 鼻成形术 鼻中隔偏曲 剥离器 鼻中隔成形 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]