湿润烧伤膏对顽固性鼻出血手术患者术后出血、鼻腔通气及应激反应的影响  

Effects of MEBO on postoperative bleeding,nasal ventilation and stress response in patients with intractable rhinorrhagia

作　　者：杨一卿 狄悦[1] 齐正元 李春娇 付志强[1] YANG Yi-qing;DI Yue;QI Zheng-yuan;LI Chun-jiao;FU Zhi-qiang(Department of Otolaryngology and Head and Neck Surgery,the First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院耳鼻咽喉头颈外科,河北秦皇岛066000

出　　处：《川北医学院学报》2024年第5期620-623,共4页Journal of North Sichuan Medical College

基　　金：河北省卫生健康委医学科学研究课题计划项目(20201907);河北省秦皇岛市科学技术局项目(202101A114)。

摘　　要：目的:探讨湿润烧伤膏联合鼻内镜下蝶腭动脉阻断术治疗顽固性鼻出血对患者出血量、鼻腔通气及应激反应的影响。方法:将97例顽固性鼻出血患者按照治疗方式不同分为对照组(n=49)和观察组(n=48)。对照组术中使用吸收性明胶海绵微填塞鼻腔;观察组术中使用涂抹湿润烧伤膏的明胶海绵微填塞鼻腔。比较两组临床疗效、出血和恢复情况、鼻腔通气情况、应激反应及并发症发生情况。结果:观察组治疗总有效率高于对照组,术后出血量少于对照组,鼻腔恢复通气时间短于对照组(P<0.05)。术后1 d、14 d、1个月,两组患者Lund-Kennedy评分、鼻吸气阻力值、鼻呼气阻力值、视觉模拟评分(VAS)、皮质醇(COR)水平均呈逐渐下降趋势,且观察组各时间点均低于对照组(P<0.05)。结论:湿润烧伤膏联合鼻内镜下蝶腭动脉阻断术治疗顽固性鼻出血可提高临床疗效,减少出血量,有效恢复鼻腔通气功能,并降低应激反应。Objective:To investigate the effects of moist exposed burn ointment(MEBO)combined with endoscopic sphenopalatine artery occlusion on the blood loss,nasal ventilation and stress response of patients with intractable epistaxis.Methods:97 cases of intractable rhinorrhagia were divided into control group(n=49)and observation group(n=48)according to different treatment methods.The control group used absorbable gelatin sponge to slightly fill the nasal cavity during surgery,and the observation group used gelatin sponge coated with MEBO to slightly fill the nasal cavity during surgery.The clinical efficacy,bleeding and recovery,nasal ventilation,stress reaction and complications were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group,the postoperative blood loss was less than that of the control group,and the recovery time of nasal ventilation was shorter than that of the control group(P<0.05).Lund-Kennedy score,naso-inspiratory resistance,naso-expiratory resistance,visual analogue score(VAS)and cortisol(COR)levels in both groups were gradually decreased at 1 day,14 days and 1 month after surgery,and the above indexes in the observation group were lower than those in the control group at all time points(P<0.05).Conclusion:MEBO combined with endoscopic sphenopalatine artery occlusion in the treatment of intractable epistaxis can improve the clinical efficacy,reduce the amount of blood loss,effectively restore the nasal ventilation function,and reduce the stress response.

关 键 词：顽固性鼻出血 鼻内镜下蝶腭动脉阻断术 湿润烧伤膏 明胶海绵 出血量 鼻腔通气 应激反应 

分 类 号：R765.23[医药卫生—耳鼻咽喉科]