鼻中隔穿孔实施鼻内镜手术治疗的临床体会

Clinical Experience of Nasal Endoscopic Surgery in the Treatment of Nasal Septum Perforation

目的:观察鼻中隔穿孔患者采用鼻内镜手术治疗的临床体会。方法:收集60例鼻中隔穿孔患者,根据穿孔直径大小分为A、B、C三组,每组20例。其中A组穿孔直径小于0.5 cm,采用鼻内镜下鼻中隔黏骨膜瓣减张的方法,修补鼻中隔穿孔。B组0.5 cm<穿孔直径≤1.5 cm,采用自体大腿阔筋膜筛骨垂直板夹层的方法,修补鼻中隔穿孔。C组穿孔直径大于1.5 cm,采用带蒂鼻腔外侧黏骨膜瓣方法,修补鼻中隔穿孔。结果:所有患者随访半年后,发现A组患者均痊愈;B组患者8例好转,12例愈合;C组患者7例好转,13例愈合。结论:采用鼻内镜下手术是治疗鼻中隔穿孔的最佳措施,能够显著缓解患者的痛苦。修补术后的保湿,抗感染可以加快伤口愈合,依据穿孔大小选择副损伤最小的手术方式及移植材料,提高手术成功率。

Objective：To observe the clinical experience of nasal endoscopic surgery in the treatment of nasal septum perforation . Method：60 patients with nasal septum perforation were collected and divided into three groups according to their hole diameter size,each of 20 cases.Group A was treated by nasal endoscopic nasal septum sticky periosteal flap reduction method,with perforation diameter less than 0.5 cm .Group B was treated by autologous thighs broad fascia ethmoid vertical powder layer,with perforation diameter between 0.5 cm and 1.5 cm.Group C was treated by pedicle lateral nasal cavity mucoperiosteal flap method,with perforation diameter more than 1.5 cm . Result：After all patients were followed up half a year,all patients in group A were recovered;8 patients in group B were better,12 cases were healed;7 patients in group Cwere improved and 13 patients were healed . Conclusion：Nasal endoscopic surgery was the best action to treat nasal septum perforation,which can significantly relieve patient’s pain.Repaired postoperative moisturizing and anti-infection can accelerate wound healing,choose operation method and graft materials according to the hole size,which shall have the least negative vice injury to improve the suegery’s success rate.