两种鼻腔填塞材料在FESS中应用的临床观察

Clinical Efficiency of Two Kinds of Nasal Packing Materials in Functional Endoscopic Sinus Surgery

目的观察可吸收性止血绫(Absorbent Stanching Satin S-100,ASS)和膨胀海绵(Merocel)在功能性鼻内窥镜(FESS)术后填塞的临床效果。方法将84例功能性鼻窦内窥镜术后患者均分为ASS组和Merocel组。两组于48 h后取出填塞物,术后系统治疗,术后1个月内镜检查,评价其疗效。结果①ASS组疼痛率和出血率分别为73.8%和29.3%;Merocel组则为42.9%和53.6%,差异均有统计学意义(P<0.05);②在窦口封闭及术腔肉芽方面ASS组(5.8%、7.1%)为与Merocel组(4.8%、8.3%)差异不大,无统计学意义(P>0.05),而在中鼻道粘连与筛窦内囊泡化方面,ASS组(3.6%、15.4%)低于Merocel组(13.1%、23.8%),差异均有统计学意义(P<0.05)。结论在FESS术中可吸收性止血绫填塞止血效果好,术腔恢复较Merocel疗效好,但疼痛率亦高。临床中应结合患者病情与两种材料的优势来进行术腔填塞。

Objective To observe the clinical efficiency of absorbent stanching satin（ASS） and Merocel for nasal packing in functional endoscopic sinus surgery（FESS）.Methods Eighty four patients with different nasal packing were divided by the packing material into ASS group and Merocel group（42 cases in each group）.The packing was taken out 48 hours after the FESS.Both groups were given the standard treatment and the curative efficacy was evaluated by the endoscopic photos after one month.Results 1.The rate of pains and bleeding were 73.8 % and 29.3 % in the ASS group,42.9 % and 53.6% in the Merocel group,the difference was statistically significance（P0.05）;2.The rate of obstruction of natural ostium of the maxillary sinus and granulation tissue in the surgical incisions were 5.8% and 7.1% in the ASS group,4.8% and 8.3% in the Merocel group,the difference was not significance（P0.05）;The rate of in adhesions in the middle meatus and vesicles in the ethmoid were 3.6% and 15.4 in the ASS group,was lower than the Merocel group（13.1% and 23.8%）,the difference was statistically significance（P0.05）.Conclusion ASS has a better hemostatic effect and rapid postoperative recovery,but a higher pain rate as compare to Merocel.The packing materials should selected according to the patient＇s condition and the advantages of materials.