慢性中耳炎术后纳吸棉填塞术腔33例

Effect of Nasopore as packing material for middle ear surgery in 33 chronic otitis media patients

目的比较慢性中耳炎术后,分别采用纳吸棉与碘仿纱条填塞术腔的不同效果。方法单耳发病的慢性化脓性胆脂瘤型中耳炎患者60例(耳),均采用开放式的改良乳突根治术及耳甲腔成形术,两组患者一般临床资料比较,差异无统计学意义(P>0.05)。术后按本人意愿,分为观察组和对照组,观察组33例(耳),术后采用纳吸棉填塞术腔;对照组27例(耳),术后采用碘仿纱条填塞术腔。比较两组患者术后并发症发生率,24 h耳痛程度,48 h内睡眠时间,术后2周取出耳部填塞物时术腔出血率。结果观察组术后并发症发生率9.1%,对照组为33.3%,两组比较差异有统计学意义(P<0.05)。术后24 h观察组耳痛程度Ⅰ级32例(耳),Ⅱ级1例(耳);对照组Ⅰ级22例(耳),Ⅱ级5例(耳),P<0.05。观察组患者术后48 h内平均睡眠时间为(15.61±0.93)h,对照组为(12.44±1.31)h,P<0.05。术后2周观察组取出耳部填塞物时出血率为6.1%,对照组为29.2%,P<0.05。结论慢性中耳炎术后采用纳吸棉填塞术腔,并发症发生率相对较低,能减轻术后疼痛、延长睡眠时间、减少创面二次损伤。

Objective To compare the effects of Nasopore and iodoform gauze as packing material in chronic otitis media surgery. Methods 60 patients with unilateral chronic otitis media and cholesteatoma underwent modified radical mastoidectomy and ear cavity angioplasty were divided into experimental group（ 33 cases） and control group（ 27cases）. Nasopore was applied in the former group but iodoform gauze in the latter group. There was no significant difference between both groups with regard to the general clinical data（ P〉0. 05）. Incidence of complications,otalgia in 24 hours,sleep time within 48 hours and bleeding rate after removing packing material 2 weeks after surgery were compared. Results The incidence of complications was 9. 1% in experimental group and 33. 3% in control group（ P〈0.05）. There was 32 cases of grade Ⅰ and 1 case of grade Ⅱ of otalgia in experimental group,but 22 cases of grade Ⅰ and 5 cases of grade Ⅱ in the control group（ P〈0. 05）. Sleep time in experimental group was（ 15. 61 ±0. 93） hours compared with（ 12. 44 ± 1. 31） hours in the control group（ P〈0. 05）. Bleeding rate was 6. 1% in experimental group compared with 29. 2% in the control group（ P〈0. 05）. Conclusion Preliminary evidence suggests that Nasopore is better than iodoform gauze as a packing material for chronic otitis media surgery,with less incidence of complications,otalgia,secondary trauma and more sleep time in the patients after middle ear surgery.