非填塞性鼻腔手术的效果

Nasal endoscopic surgery without nasal packing

目的探讨非填塞性鼻腔手术的优缺点。方法所有鼻内镜手术患者随机分为2组：A组（n=226例，术后鼻腔不填塞，仅以菲薄的生物胶覆盖创面）和B组（n=50例，术后鼻腔用医用膨胀海绵或凡士林油纱条填塞），临床数据比较分析。鼻腔术后仅对活动性出血进行彻底止血，创面渗血则不予处理，鼻腔不填塞保持通畅。结果非填塞患者与填塞患者相比，术后渗血时间及渗血量无明显差异，而术后头痛、鼻阻等并发症则明显好于填塞患者（均P〈0．01）。结论鼻腔术后不填塞，能显著减轻患者头痛、鼻塞等并发症而术后渗血等不良反应无明显增加。

Objective To approach the merit and demerit of endoscopic sinus surgery without nasal packing. Methods A retrospective analysis of 276 cases of nasal endoscopic surgery was performed between April 2007 and May 2008 in the General Hospital of Chinese People＇s Armed Police Forces. All patients were divided into two groups according to postoperative nasal packing： group A （n=226, no packing） and group B （n=50, medical sponge or oiled gauze）. The clinical symptoms and complications were compared with two groups. The active bleeding in the surgery must be stopped thoroughly. The errhysis in the wound surface can not be dealt with. The patient without nasal packing could keep the nasal cavity unobstructed. Results There was no significant difference in the time and the quantity of the postoperative nasal errhysis between two groups. The group B, as compared with the Group A, there was significant difference in the headache and nasal obstruction after the surgery. Conclusion The nasal endoscopic surgery without nasal packing has the advantage causing significantly less pain and less obstructive in nasal cavity. No nasal packing should be considered the procedure of choice for performing the nasal endoscopic surgery.