鼻腔内镜手术后填塞止血材料的选择

Choice of hemostatic materials for nasal packing after masal endoscopic surgery

目的:探讨鼻腔内镜手术后合适的鼻腔止血材料和填塞方法的选择。方法:将临床上80例行鼻腔内镜手术后的患者随机分成四组,A组42例使用凡士林纱条填塞,B组9例用高分子棉填塞,C组5例使用明胶海绵填塞,D组24例使用明胶海绵加凡士林纱条填塞,统计术后出血量及时间,及重新填塞次数和并发症。结果:(1)出血:A组术后渗血3例,纱条抽出后出血2例。B组术后渗血2例,填塞状态下出血1例,C组海绵抽出后出血1例。(2)填塞时间:A组48小时后出血量明显,延迟1～2天抽完纱条。(3)重新填赛次数:A组重新填塞2例,B组重新填塞1例,C组重新填塞2例。(4)并发症:A组眶周血肿1例,B和C组鼻中隔血肿2例。结论:应根据术腔情况选择不同的填塞材料,避免出血和并发症。

Objective：To investigate the proper choice of hemostatic materials and packing method for nasal packing after nasal endoscopic surgery.Methods：Eighty eases of all sorts of nasal endoscopic surgery were randomly divided into four groups.Vaseline gauxe packing was used in 42 eases （group A）,maeromoleeular material packing was used in 9 eases （group B）,glutin sponge packing in 5 eases （group C）,vaseline gauxe plus glutin sponge packing in 24 eases （group D）.The volume and time of pastoperative bleeding, the number of repetitive packing and complication were observed.Resuls：（1）Bleeding：the postoperative ooxing of blood was 3 eases and bleeding after the abstraction of packing material was 2 eases in group A.The postoperative oozing of blood was 2 eases and bleeding under packing was 1 ease in group B as well as bleeding after the abstraction of packing material was 1 ease in group C.（2）The time of packing：The volume of bleeding was obvious in 48 hours after operation ha group A,the obstraetion of packing material was postponed for 1 to 2 days.（3）The number of packing：the repetitive packing was 2 eases in group A,1 ease in group B and 2 eases in group C.（4）Complieation：the periorbital hematoma was 1 ease in group A,the nasal septum hematoma was 2 eases,1 ease in group B and another one in group C.Condusion：In order to prevent the postoperative bleeding and complication,the different kinds of packing materials should be ehasen according to the nasal condition.