负压吸引技术在老年人鼻中隔矫正术后的应用价值

Application of negative pressure sucking technique in the elderly after nasal septal reconstruction

目的评价负压吸引技术在老年人鼻中隔矫正术后的应用价值。方法将接受鼻中隔矫正手术后的老年患者，分为接受负压吸引技术的研究组（20例）和接受传统的凡士林纱条填塞方法的对照组（20例），对比观察术后24h出血量、舒适度评分[采用视觉模拟评分法（VAS）]、术后鼻腔血肿和水肿、术后住院时间等临床指标。结果术后24h研究组出血量为（14．2±8．1）ml，虽明显多于对照组的（7．2±4．1）ml，但两组的出血量均较少，无临床意义；在术后6h、12h和24h，无论是VAS读数，还是中度、重度不适的病例数，研究组均明显少于对照组（P〈0．01）；研究组术后1周的血肿发生例数少于对照组，术后3d的鼻腔间隙明显宽于对照组（P〈0．01）；研究组术后住院时间（4．5±0．9）d，短于对照组（5．4±0．9）d（P〈0．05）。结论对于接受鼻中隔矫正手术的老年患者，术后应用负压吸引技术，不增加出血风险，明显减轻患者痛苦，减轻鼻腔水肿和缩短术后住院时间。

Objective To investigate the application value of negative pressure sucking technique in the elderly after nasal septal reconstruction. Methods Forty elderly patients after nasal septal reconstruction were divided into two groups randomly, with twenty patients in each. The cases in observing group received negative pressure sucking technique while those in controlling group received nasal packing with vaseline gauze following the surgery. The amount of bleeding of the first 24 hours after operation, the comfort degrees evaluated by using visual analogue scale （VAS）, hematoma of nasal septum, edema in nasal cavity and duration of hospitalization after operation were compared between the two groups. Results The amount of bleeding of the first 24 hours afteroperation was more in observing group than in controlling group[（14.2 ± 8.1）ml vs. （7.2 ± 4.1）ml, P〈0.05]. The VAS score and the number of cases who felt discomfortable moderately or severely were significantly less in observing group than in controlling group at 6 h, 12 h and 24 h after operation（all P〈0.05）. The nasal cavity gap were significantly wider in observing group at the 3rd day after operation（P= 0. 001）, and the duration of hospitalization after operation was significantly shorter in observing group [（4.5 ± 0.9） d] than in controlling group [（5.42± 0.9） d]（P=0. 042） Conclusions Negative pressure sucking technique applied in the elderly after nasal septal reconstruction can significantly relieve the distress of patients, reduce the edema in nasal cavity and shorten the duration of hospitalization, but does not increase the risk of hemorrhage.