利多卡因明胶纤维网对鼻内镜术后止血止痛效果观察

Effect of lidocaine gelatin fiber on analgesia and hemostasis after endoscopic sinus surgery

目的 探讨利多卡因明胶纤维网对鼻内镜鼻窦手术后的止血及止痛效果。方法 择期鼻内镜手术治疗的鼻窦炎患者86例按数字表法随机分为两组,A组43例,术后用20%利多卡因明胶纤维网＋膨胀止血海绵填塞术腔。B组43例,膨胀止血海绵填入术腔。均于术后24 h抽取鼻腔填塞物,观察患者填塞后24 h内鼻腔渗血量、抽除填塞物时鼻腔出血量及止血止痛材料鼻腔填塞后1 h、6 h、12 h及24 h止痛效果。结果 两组24 h内出血量差异有统计学意义［（16.30±5.19）ml与（32.30±12.09）ml,t=7.97,P＜0.05］,抽除填塞物时鼻腔出血量差异无统计学意义［（3.30±2.12）ml与（5.30±2.10）ml,t=1.40,P＞0.05］。两组术后1 h止痛有效率差异无统计学意义（P＞0.05）,6～24 h A组止痛效果优于B组（t=27.163、29.091、16.241,均P＜0.01）。结论 利多卡因明胶纤维网对鼻内镜鼻窦手术后的止血及止痛效果优于膨胀止血海绵。

Objective To explore the analgesic and hemostatic effect of lidocaine gelatin fiber used after endoscopic sinus surgery.Methods 86 patients underwent endoscopic sinus surgery were randomly divided into A and B groups.In A group,20% lidocaine gelatin fiber and expansion hemostatic sponge was packed into 43 patients′ nasal cavity,while in B group,only expansion hemostatic sponge was packed.Nasal bleeding in patients while packed material within 24 hours and when extracted the material were observed.The analgesic effects were evaluated after packing material 1,6,12,and 24 hours after surgery.Results In A group,the amount of bleeding was （16.30±5.19）ml,while the amount was（32.30±12.09）ml in group B.Statistical analysis showed significant difference（t=7.97,P〈0.05）.There were no significant differences in nasal bleeding when extracted the stuffing and in analgesic efficiency 1 hour after surgery.But the analgesic efficiency of lidocaine gelatin fiber was 20%,which was better than expansion hemostatic sponge 6～24 hours after surgery（t=27.163,29.091,16.241,all P〈0.05）.Conclusion Lidocaine gelatin fiber not only had better hemostasis,but also had better analgesia than expansion hemostatic sponge after endoscopic sinus surgery.