鼻中隔偏曲矫正术使用鼻腔填塞与负压引流的对比研究

王春燕; 薛俊芳; 刘芳; 王建军; 赵励; 王钰

doi:10.13201/j.issn.1001-1781.2015.05.018

鼻中隔偏曲矫正术使用鼻腔填塞与负压引流的对比研究

- 北京大学首钢医院耳鼻咽喉科(北京, 100144)

详细信息

通讯作者: 王春燕,E-mail:50953008@qq.com

中图分类号: R765.3

收稿日期: 2015-01-10

Comparative study of nasal packs and postoperative negative-pressure septal drainage in patients undergoing nasal septal surgery

- Department of Otolaryngology, the Shougang Hospital of Peking University, Beijing, 100144, China

More Information

Corresponding author: WANG Chunyan, E-mail: 50953008@qq.com

Received Date: 10 January 2015

摘要

摘要: 目的: 探讨一种新的鼻中隔偏曲矫正术后处理方法——负压引流的可行性,观察与鼻腔填塞法相比是否存在优势。方法: 通过前瞻性病例-对照研究将拟行鼻中隔偏曲矫正术的60例患者随机分为鼻腔填塞组和鼻中隔负压引流组,比较2组患者术后24 h及48 h在伤口疼痛、口干、睡眠障碍、结膜充血、术后局部换药操作时的不适感及出血情况的VAS评分,并于术后1、6周随诊,了解发生再次出血、鼻中隔穿孔、粘连、局部感染等情况的差异。结果: 在术后24、48 h伤口疼痛、口干、睡眠障碍、结膜充血、术后取纱条或拔出引流管时的不适感及出血情况6个方面,鼻腔填塞组的VAS评分均大于鼻中隔负压引流组(均P<0.05);尤其在48 h换药时,鼻腔填塞组的出血量[(21.03±5.88)ml]大于负压引流组[(0.52±0.63)ml](P<0.01)。术后1、6周随访,2组间疼痛或并发症等数据比较差异无统计学意义(P>0.05)。结论: 鼻中隔偏曲矫正术使用鼻中隔负压引流切实可行,与鼻腔填塞相比,能明显减轻患者的痛苦,且不增加术后并发症发生的概率,值得推广和应用。
- 鼻中隔偏曲矫正术 /
- 鼻中隔负压引流 /
- 鼻腔填塞
Abstract: Objective: To study whether negative-pressure septal drainage could be an alternative to packs after septoplasty.Method: This was a randomized controlled trial. The study involved 60 patients who underwent septoplasty. Patients were randomly divided into two groups, one with anterior nasal packs and the other with negative-pressure septal drainage. Patients were asked to record pain levels using a visual analogue scale (VAS). Postoperative symptoms and complications were compared during 24 h and 48 h postoperative period including pain, drying sensation of mouth, sleep difficulty, conjunctival congestion, haemorrhage. VAS scores and incidence were evaluated during 1 week and 6 weeks postoperative period including pain, bleeding, haematoma, septal perforation, synechiae and septal perforation.Result: Patients of negative-pressure septal drainage suffered from less pain than patients of nasal packs during the first 24 h and 48 h postoperative period. The results for pain, drying sensation of mouth, sleep difficulty, conjunctival congestion, haemorrhage were different between groups (P<0.05), especially the amount of bleeding during 48 h postoperatively in patients undergoing negative pressure drainage[(0.52±0.63)ml]was significantly less than the group who received anterior nasal packs[(21.03±5.88)ml](P<0.01).On the other hand, haematoma, synechiae and perforation were not statistically different between groups during 1 week and 6 weeks follow-up period(P> 0.05).Conclusion: Using negative-pressure drainage instead of nasal packs after septoplasty seems a more reasonable option.The negative-pressure drainage technique may be the preferred option to provide higher patient satisfaction and has the same level of postoperative complication to nasal packs as for septoplasty surgery.
- septoplasty /
- negative-pressure drainage /
- nasal packs

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