四种鼻腔填塞材料的疗效比较  

Effect comparison of four kind of nasal packing materials

作　　者：谢民强[1] 许庚[1] 李源[1] 李仲汉[1] 李永奇[1] 史剑波[1] 吕剑霆[1] 刘贤[1] 陈合新[1] 王涛[1] 

机构地区：[1]中山大学附属第三医院耳鼻咽喉科,广东广州510630

出　　处：《中国内镜杂志》2003年第12期19-22,共4页China Journal of Endoscopy

摘　　要：目的　为了比较不同填塞材料的止血效果及在鼻腔的留置时间。方法　对 80例慢性鼻窦炎 ,36例鼻中隔偏曲术后及 2 0例鼻出血患者分别采用凡士林纱条 (40例 )、瑞纳凝胶快速止血材料 (Gel-Knit ,35例 )、藻酸钙纤维 (Sorbalgon ,2 3例 )和膨胀海绵 (Merocel,38例 )四种材料填塞鼻腔 ,2 4～ 4 8h取出填塞物 ,根据填塞后鼻腔胀痛、头痛程度 ,取出填塞物后鼻腔出血程度等评价疗效。结果　凡士林纱条填塞组 ,87.5 %有鼻腔胀痛或头痛 ;Cel-Knit组 5 .7% ;SorbalSon组 4 .3% ;Merocel组 4 7.4 % ,四组比较差异非常显著 (P <0 .0 1)。取出填塞物后鼻腔再出血分别为 95 % ,8.6 % ,4 .3%和 5 0 % ,四组比较差异非常显著 (P <0 .0 1)。结论　凡士林纱条填塞止血效果虽然好 ,但严重头痛使患者难以接受 ,而且即使 4 8h后取出再出血的机会仍很大。Gel-Knit和Sorbalgon疗效确切 ,在鼻腔留置时间短 ,几乎没有上述副反应 ,但前者价格较高 ,后者不适合鼻中隔成形手术。Merocel的疗效介于凡士林纱条和后二者之间 ,取出后有再出血的可能 ,但应用范围更广。Objective: To compare the haemostasis effect of four different nasal packing materials and their leaving times in place.Methods:Total 136 patients, 80 cases with chronic sinusitis and underwent endoscopic sinus surgery, 36 cases with nasal septum deviation and underwent septoplasty, and 20 cases with epistaxis, were randomly packed using four different haemostasis materials. In which, paraffin gauze group was 40 cases, rapid RHINO Gel-Knit group 35 cases, Sorbalgon group 23 cases and Merocel group 38 cases. The packing materials were removed after left for 24 hours to 48 hours. The efficacy of nasal packing materials was assessed in terms of the levels of nasal pain or headache in the leaving period and nasal bleeding after removal of nasal packing.Results:The incidence rate of nasal pain or headache respectively was 87.5% in paraffin gauze group, 5.7% ia Gel - Knit, 4.3% in Sorbalgon and 47.4% in Merocel. The significant statistical difference was observed between the four groups ( χ 2 = 73.46, P < 0.01 ). The incidence rate of nasal bleeding after removed was 95%, 8.6%, 4.3% and 50% respectively. The statistical difference was also sigmficant (χ 2 = 59.58, P < 0. 01 ).Conclusions:Paraffin gauze do well in controlling nasal bleeding,but it may cause a bad headache and even removed after a delay of 48 hours, there is a great probability of repeated bleeding. Gel- Knit and Sorbagon also do well in control bleeding and their leaving period in nose are shorter than other two materials .hardly with headache and repeated bleeding. But the former is expensive while the latter is not adapted to septoplasty. The effect of Merocel is between paraffin gauze and the above two packing materials. Though Merocel may have a risk of repeated bleeding, its indications are more widerly.

关 键 词：鼻腔鼻窦手术 鼻出血 鼻腔填塞 止血材料 

分 类 号：R969.4[医药卫生—药理学]