Nasopore鼻腔局部联合注射血凝酶在鼻内镜术后止血效果的观察

A double-blind RCT of the hemostatic effects of local packing of Nasopore combined with hemocoagulase injection for postoperative management of FESS

目的:采用双盲随机对照临床试验比较功能性鼻内镜术后术腔Nasopore联合注射血凝酶和Nasopore联合生理盐水鼻腔填塞的止血效果。方法:选择确诊为慢性鼻-鼻窦炎需行功能性鼻内镜手术患者68例,随机分为实验组40例和对照组28例。实验组术后给予Nasopore+注射血凝酶填塞(注射血凝酶均使用1U,使用前将其溶解于0.5ml生理盐水中),术毕将溶解有注射血凝酶的生理盐水注入已填入鼻腔的Nasopore中;对照组术后给予纳吸绵填塞,术毕将0.5ml生理盐水注入已填入鼻腔的Nasopore中。通过患者术后VAS评分比较两组在功能性鼻内镜手术后出血效果的差异。结果:对照组术后6h鼻出血VAS评分分别与同组术后1、2、3d比较,差异有统计学意义(P<0.05);实验组术后6h的鼻出血VAS评分分别与同时段对照组比较,差异有统计学意义(P<0.05)。结论:功能性鼻内镜手术后使用Nasopore作为鼻腔填塞物联合局部使用注射血凝酶,可以有效减少术后6h内的出血。

Objective： To compare the hemostatic effects of local packing of Nasopore combined with hemo- coagulase injection and local packing of Nasopore combined with saline injection for postoperative management of functional endoscopic sinus surgery by a double-blind, randomized control clinical trial. Method： Sixty-eight cases ofchronic sinusitis needed functional endoscopic sinus surgery were randomly divided into the experimental group of 40 cases and control group of 28 cases, respectively. For the experimental group, 1 U of hemocoagulase dis- solved in 0.5 ml saline was injected into Nasopore which was packed into the nasal cavity after operation. For the control group, 0.5 ml of saline was injected. The postoperative bleeding of the two groups were scored by visual analogue scale. Result： There was statistically significant difference between the bleeding VAS scores assessed 6 hours and the ones assessed 1, 2 and 3 days after the operation in the control group（P〈0.05）. There was the sta- tistically significant difference between the bleeding VAS scores of experimental group and control group assessed 6 h after the operation （P〈0.05）. Conclusion：The hemocoagulase may improve the hemostatie effect of Nasopore 6 hours after the operation by combined injection with Nasopore as nasal cavity packing.