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摘要: 目的:探讨改良的鼻中隔缝合法应用于鼻中隔偏曲矫正术能否替代目前术后鼻腔填塞法。方法:通过前瞻性病例-对照研究将拟行鼻中隔偏曲矫正术患者40例随机分为鼻中隔缝合非鼻腔填塞组(缝合组,20例)与鼻中隔非缝合鼻腔常规填塞组(填塞组,20例)。比较2组患者术后48 h主观不适感的视觉模拟量表(VAS)、术后2周时客观鼻阻力测试以及术后2周门诊随访时患者鼻内镜下术腔并发症。结果:填塞组患者术后的VAS评分均值大于缝合组(P<0.05);2组患者术前及术后2周在鼻阻力方面差异无统计学意义(P>0.05);术后2周门诊鼻内镜检查2组患者术后均未出现鼻出血、鼻中隔穿孔、鼻中隔血肿等并发症。但填塞组有1例出现鼻腔粘连,2例出现鼻前庭区肿胀、溃烂,1例出现鼻腔异味。填塞组14例患者撤出鼻腔通气管时,发现其内有大量血痂滞留,堵塞管道,致鼻通气不良;而缝合组未出现上述体征。结论:改良的鼻中隔缝合法较目前的鼻腔填塞法具有操作简单、无明显术后并发症、术后鼻腔通气良好等优点,值得推广及应用。Abstract: Objective: To study whether modified transseptal suturing could be an alternative to packing after septoplasty. Method: We conducted a prospective randomized controlled trial. The study involved 40 patients who underwent septoplasty. Patients were randomly divided into two groups, one with anterior nasal packing and the other with modified transseptal suturing. Patients were asked to record their subjective discomfort levels on a visual analogue scale(VAS) during 48 h postoperatively. Both groups were compared for VAS, postoperative complications 2 weeks after septoplasty through nasal endoscope, the datum of rhinomanometry before surgery and 2 weeks after surgery. Result: The differences of mean postoperative VAS score between two groups were statistically significant(P<0.05). The patients of nasal packing group experienced more discomforts than the other group. No statistically significant between two groups in terms of the datum of rhinomanometry before surgery and 2 weeks after surgery(P>0.05). There were no bleeding, septal hematoma, nasal septum perforation and local infection in all patients 2 weeks after septoplasty. During follow-up 1 case was found with postoperative nasal adhesion, nasal vestibular swelling and fester were seen in two patients and nasal peculiar smell was found in 1 case in nasal packing group. We can find that there were a lot of blood crust in silicone ventilation tube about in 14 patients in packing group. However, the suturing group could see none of the above questions.Conclusion: Modified transseptal suturing is more simple and convenient than nasal packing. In a word, the use of modified transseptal suturing could be an alternative topacking after septoplasty.
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Key words:
- septoplasty /
- transseptal suturing /
- nasal packing /
- rhinomanometry
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