可吸收性止血颗粒在鼻内镜下经口腺样体吸切术中的应用

Topical Application of Arista AH in Transoral Endoscopic Adenoidectomy

目的:探讨可吸收性止血颗粒(Arista AH)在鼻内镜下经口腺样体吸切术创面止血上的应用效果。方法:54例腺样体肥大患者行鼻内镜下经口腺样体吸切术,随机分为四组,A组20例(压迫止血后喷洒Arista AH),B组15例(压迫止血后双极电凝止血),C组7例(压迫止血后Merocel高膨胀海绵填塞),D组12例(仅压迫止血)。比较四组患者的止血时间、术后出血、咽痛持续时间、恢复正常通气时间等指标,同时采用视觉模拟评分法记录止血难度的主观评估。结果:A组手术时间、止血难度均低于B组、D组,差异具有统计学意义(P<0.05),与C组无统计学差异(P>0.05)。而A组术后出血发生率低于D组(P<0.05),与B组、C组无统计学差异。A组咽痛持续时间低于B组、C组,差异具有统计学意义(P<0.05),与D组无统计学差异(P>0.05)。而A组恢复正常通气时间与B组、D组无统计学差异(P>0.05)。结论:可吸收性止血颗粒可用于鼻内镜下经口腺样体吸切术创面止血,具有快速简便、安全有效的特点。

Objective： To evaluate the efficacy of Arista Absorbable Hemostat （Arista AH） in transoral edoscopic adenoidectomy. Methods： In total, 54 patients underwent transoral edoscopic adenoidectomy and were then randomly divided into A group （Arista AH）, B group（bipolar electrocautery）, C group（Merocel packing） and D group（compression）. Datum collected were analyzed, including time of hemostasis, the incidence of postoperative bleeding, time of angina and days to normal ventilation. Visual analog scales （VAS） were used to record difficulty ofhemostasis by the operation surgeon. Results： Those in A group had significantly shorter operation times than B and D group. The difference of operation time between A and C group failed to obtain statistical significance. The Patients in A group had less incidence of postoperative bleeding than D group. No difference in postoperative bleeding between A and B, C group was found. Regarding difficulty of hemostasis, the VAS score showed a signifcant reduction in A group in a comparison between A and B, D group. The patients in A group had significantly shorter time of angina than B and C group. Days to normal ventilation displayed a signifcant delay in C group. No difference of time of returning to normal ventilation between A and B, D group was found. Conclusion： Topical application ofArista AH during adenoidectomy proves to be rapid, simple, effective and safe.