改良自制鼻咽通气管在FESS术后填塞中的应用

Application of modified naso-pharyngeal tube in postoperative packing of FESS

目的在功能性内镜鼻窦手术(FESS)后鼻腔填塞的同时使用改良自制鼻咽通气管,研究患者临床症状的改善情况。方法收集2013年1月至2015年3月行双侧FESS手术162例的临床资料,其中83例术后鼻腔填塞时使用改良自制鼻咽通气管(观察组),79例不采用通气管(对照组)。记录手术时间等指标,采用视觉模拟量表(VAS)评价患者填塞后头痛、鼻部胀痛、睡眠情况、咽部不适等症状。结果在术后24 h的VAS评分比较中,头痛症状观察组为3.1±1.2,对照组为5.2±7.5;鼻部胀痛症状评分观察组为3.5±1.5,对照组为6.1±1.7;睡眠评分观察组为3.3±1.2,对照组为4.8±1.6,差异均有统计学意义(P<0.05)。咽部不适症状评分观察组为4.1±1.5,对照组为4.5±1.6,差异无统计学意义(P=0.10)。结论鼻腔FESS手术后应用改良自制鼻咽通气管能有效改善患者术后疼痛等临床症状。

Objective To study the improvement of postoperative discomfort by application of modified naso-pharynge- al tube when nasal packing after functional endoscopic sinus surgery （FESS）. Methods A total of 162 patients under- gone bilateral FESS in department of otolaryngology from January 2013 to March 2015 were enrolled in this study. 83 patients of them had been given nasal packing with modified naso-pharyngeal tube after operation （ the experimental group）, while 79 of them were not given naso-pahryngeal tube （the control group）. All were recorded clinical indexes including operation time, and were evaluated and recorded by Visual Analogue Scale （VAS） for symptoms such as post-packing headache, nasal distending pain, sleep condition and pharyngeal discomfort, Results Post-operative 24 h VAS scores of the two groups showed the experimental group had better outcome in headache, nasal distending pain and sleep condition than the control group （P 〈 0. 05 ）. While for pharyngeal discomfort, there were no statistically signifi- cant differences between the two groups. Conclusion Post-operative application of modified nasopharyngeal tube of FESS can effectively improve clinical symptoms such as postoperative pain.