改良三线减张和精准延时填塞在鼻中隔矫正中的疗效分析  

Efficacy analysis of modified three-line tension reduction and precise delayed tamponade in nasal septum correction

作　　者：王干 陈志凌 段汉忠 WANG Gan;CHEN Zhiling;DUAN Hanzhong(Department of Otolaryngology,Hangzhou Hospital of Traditional Chinese Medicine,Zhejiang University of Traditional Chinese Medicine,Hangzhou 310007,Zhejiang,China)

机构地区：[1]浙江中医药大学附属杭州市中医院耳鼻咽喉科,浙江杭州3100071

出　　处：《中国现代医生》2024年第9期44-47,共4页China Modern Doctor

基　　金：杭州市科技局引导项目(20220919Y041)。

摘　　要：目的探讨改良三线减张和精准延时填塞在鼻中隔矫正中的疗效。方法选取2021年1月至2023年1月在浙江中医药大学附属杭州市中医院耳鼻咽喉科行鼻中隔偏曲手术患者94例,随机分为A组和B组,每组47例。A组患者采取传统鼻中隔三线减张治疗;B组患者采取鼻中隔改良三线减张治疗,双侧鼻腔填塞取出后偏曲部位碘仿纱条精准填塞2周。比较两组患者的手术时间、术中鼻中隔黏膜损伤情况、术中出血量等。主观症状采用鼻阻塞症状评估(nasal obstruction symptom evaluation,NOSE)评分;鼻中隔偏曲情况采用鼻内镜检查评估。结果A组术中黏膜损伤例数多于B组;A组患者的手术时间长于B组,差异有统计学意义(P<0.05);A组患者的手术出血量多于B组,差异有统计学意义(P<0.05);术后两组患者的鼻塞症状均改善,B组患者的鼻塞症状改善效果更好,差异有统计学意义(P<0.05);两组患者的鼻中隔偏曲情况均得到改善,且B组患者的鼻中隔塑形较A组改善效果更好,差异有统计学意义(P<0.05)。结论鼻内镜下改良三线减张可达到传统三线减张鼻中隔矫正术相同的效果,同时可缩短手术时间、减少出血量、降低鼻中隔穿孔风险,精准延时微填塞2周左右可避免鼻中隔软骨弹性回缩,提高手术效果。Objective To explore the efficacy of modified three-line tension reduction and precise delayed tamponade in nasal septum correction.Methods From January 2021 to January 2023,a total of 94 patients who underwent nasal septum deviation surgery in Department of Otolaryngology,Hangzhou Hospital of Traditional Chinese Medicine,Zhejiang University of Traditional Chinese Medicine were randomly divided into group A and group B,with 47 cases in each group.Patients in group A were treated with traditional nasal septum three-line tension reduction;Patients in group B were treated with modified three-line tension reduction of nasal septum,and iodoform gauze was accurately filled in the deviated part after bilateral nasal tamponade was removed for 2 weeks.The operation time,intraoperative nasal septum mucosal injury and intraoperative blood loss were compared between the two groups.Subjective symptoms were scored by nasal obstruction symptom evaluation(NOSE).Nasal septum deviation was evaluated by nasal endoscopy.Results The number of cases of mucosal injury in group A was more than that in group B;The operation time of group A was longer than that of group B,and the difference was statistically significant(P<0.05).The amount of bleeding in group A was more than that in group B,and the difference was statistically significant(P<0.05).The nasal obstruction symptoms of two groups were improved after operation,and the improvement effect of nasal obstruction symptoms in group B was better,the difference was statistically significant(P<0.05).The deviation of nasal septum in both groups was improved,and the improvement of nasal septum shaping in group B was better than that in group A,the difference was statistically significant(P<0.05).Conclusion The modified three-line tension reduction under nasal endoscopy can achieve the same effect as the traditional three-line tension reduction nasal septum correction.At the same time,it can shorten the operation time,reduce the amount of bleeding,reduce the risk of nasal septum perforation,

关 键 词：鼻中隔偏曲 改良三线减张 精准延时鼻腔填塞 

分 类 号：R725.6[医药卫生—儿科]