三种鼻腔填塞材料在鼻内镜手术中的疗效比较

Effect of three nasal packing materials in functional endoscopic sinus surgery

目的：探讨三种鼻腔填塞材料在鼻内镜手术中的应用效果。方法：2004年1月至8月为慢性鼻窦炎、鼻息肉75例行内窥镜鼻窦手术，男49例，女26例，平均42岁。Ⅱ型2期36例，Ⅱ型3期21例，Ⅲ型18例。局部或全身麻醉下行Messerklinger鼻窦内窥镜手术，术后随机予以凡士林油纱条、Merocel高分子止血棉、瑞纳凝胶快速止血材料中的一种填塞鼻腔，每组25例，48～72h后取出填塞物，观察患者鼻痛、头痛的程度及取出填塞物后的渗血情况，判断疗效。结果：凡士林油纱条组80％的患者出现鼻痛、头痛等症状，64％的患者抽出鼻腔填塞物后有渗血；瑞纳凝胶快速止血材料组60％的患者出现鼻痛、头痛等症状，12％的患者抽出鼻腔填塞物后有渗血；Merocel高分子止血棉组44％的患者出现鼻痛、头痛等症状，24％的患者抽出鼻腔填塞物后有渗血；三组比较差异有统计学意义（P〈0．05）。结论：三种鼻腔填塞材料中凡士林油纱条疗效可靠，价格低廉，但痛苦明显；Merocel高分子止血棉、瑞纳凝胶快速止血材料止血效果好，痛苦小，但价格略昂贵，临床应用中可视情况而定。

Objective： To investigate the effect of three nasal packing materials in functional endoscopic sinus surgery. Methods： Seventy-five patients with chronic rhinosinusitis and nasal polyp were treated with functional endoscopic sinus surgery. After surgeries, voseline strips gauze, Merocel and Rapid-Rhina were used at random and were taken out 48-72 hours later. Results： About 80% of the patients in group of voseline strips gauze felt pain, 60% of them still had bleeding after being taken out the nasal packings; about 60% of the patients in group of Rapid-rhina felt pain, and 12% of them had bleeding after being taken out the nasal packings; 44% of the patients in group of Merocel felt pain, and 24% of them had bleeding after being taken out the nasal packings. Conclusions： All the three nasal packing materials have good effect. Voseline strips is cheap but brings much pain to the patients, while Merocel and Rapid-rhina makes patients feel comfortable but is expensive.