纳吸棉和膨胀海绵填塞对慢性鼻-鼻窦炎鼻内镜术后鼻腔黏膜转归的影响

Effects of absorbing cotton and expansion sponge filling after endoscopic sinus surgery on outcomes of nasal mucosa with chronic rhinosinusitis

目的探讨鼻内镜手术后采用纳吸棉和膨胀海绵两种材料填塞鼻腔对慢性鼻-鼻窦炎患者术后鼻腔黏膜转归的影响。方法选取该院耳鼻喉科慢性鼻-鼻窦炎患者70例,收治时间为2014年1月‐2015年12月,随机分成A、B两组,每组35例。A组鼻内镜术后采用纳吸棉填塞鼻腔,B组鼻内镜术后采用膨胀海绵填塞鼻腔,通过比较两组患者的LundMackay鼻窦CT评分、视觉模拟评分法(VAS)和鼻内镜Lund-Kennedy评分来比较两组患者术后鼻腔黏膜修复情况。结果两组患者术前VAS和Lund-Kennedy分值比较差异无统计学意义(P>0.05);A组术后6周及术后12周的VAS评分均低于B组,比较差异有统计学意义(P<0.05);A组患者术后各时间点的Lund-Kennedy评分均低于B组,比较差异有统计学意义(P<0.05)。结论慢性鼻-鼻窦炎患者鼻内镜术后采用纳吸棉填塞鼻腔较采用膨胀海绵填塞能够更有效地促进术腔黏膜良性转归过程。

[Objective] To investigate the effect of two kinds of nasal packing materials, including absorbing cotton and expansion sponge, on the benign outcomes of nasal mucosa of patients with chronic rhinosinusitis after endoscopic sinus surgery. [Methods] Senventy cases of patients with chronic rhinosinusitis treated from January 2014 to December 2015 in our hospital were selected, and randomly divided into two groups, with 35 cases in each group. Group A was treated with nasal packing after endoscopic sinus surgery, and group B was treated with expanded sponge packing. The Lund-Mackay CT score, visual analogue scale （VAS） and endoscopic Lurid-Kennedy score were compared between the two groups to compare the postoperative nasal mucosal repair. [Results] There was no significant difference in VAS and Lurid-Kennedy scores between the two groups before surgery （P 〉0.05）. The VAS score of group A was lower than that of group B at 6, and 12 weeks after the operation, and the difference was statistically significant （P 〈0.05）. The Lund-Kennedy scores of group A were significantly lower than those of group B at each time point after the surgery （P 〈0.05）. [Conclusion] It is more effective to promote the benign outcomes of nasal mucosa by filling the nasal cavity with the absorbing cotton than the expansion sponge after nasal endoscopic surgery.