鼻中隔成形术中鼻腔填塞法及鼻中隔缝合法治疗鼻中隔偏曲的疗效对比研究

Comparative Study on Nasal Septum Deviation by Intranasal Tamponade and Nasal Septum Suture

目的对比观察鼻中隔成形术中鼻腔填塞法及鼻中隔缝合法治疗鼻中隔偏曲的疗效。方法回顾性分析2016年12月—2017年12月间于该院耳鼻咽喉科行鼻中隔成形术的116例鼻中隔偏曲患者的临床资料,按照治疗方法的不同分为观察组(62例,采取鼻中隔缝合法治疗)和对照组(54例,采取鼻腔填塞法治疗)。术后随访7 d,观察两组患者治疗效果及相关并发症的发生情况;于术前及术后2 d采用视觉模拟评分法(VAS)对患者舒适程度进行评价,于术后3 d,观察两组患者鼻粘膜水肿情况。结果观察组总有效率为98.39%,明显高于对照组88.89%(χ~2=4.59);手术2 d后,两组患者VAS评分明显降低,且观察组患者VAS评分显著低于对照组[(4.23±1.02)分vs(5.82±1.34)分,t=7.24];术后3 d,观察组鼻粘膜水肿0级患者所占比例明显高于对照组(33.87%vs9.26%,χ~2=10.05),2级所占比例明显低于对照组(9.68%vs 31.48%,χ~2=8.63),差异有统计学意义(P<0.05)。观察组术后7 d内并发症发生率低于对照组(9.68%vs 20.37%),但差异无统计学意义(χ~2=2.64,P=0.10)。结论相比于鼻腔填塞法,在鼻中隔成形术中采用鼻中隔缝合法治疗鼻中隔偏曲效果更为显著,能够明显改善患者术后头痛、鼻部肿胀、流泪和鼻塞情况,以及鼻粘膜水肿情况,值得推广应用。

Objective This paper tries to observe the the curative effect of nasal septum legitimate and nasal packing in the treatment of septal deviation. Methods The clinical data of 116 patients with deviated nasal septum who had undergone nasal septum surgery in this hospital from December 2016 to December 2017 were retrospectively analyzed.According to the different treatment methods, they were divided into observation group（62 cases, taking nasal septum legitimate treatment） and control group（54 cases treated with nasal packing）. After 7 days follow-up, the treatment effect and related complications of the two groups were observed. The visual analog scale（VAS） was used to evaluate the comfort level of the patients before and two days after operation. The nasal mucosa edema was seen in both groups.Results The total effective rate in the observation group was 98.39%, which was significantly higher than that in the control group（88.89%）（χ~2=4.59）. After 2 days of surgery, the VAS scores of the two groups decreased significantly, and the VAS scores of the observation group were significantly lower than the control group [（4.23±1.02）points vs（5.82±1.34）points, t=7.24]; At 3 days after surgery, the proportion of patients with grade 0 nasal mucosa edema was significantly higher in the observation group than in the control group（33.87% vs 9.26%, χ~2=10.05）, and the proportion of grade 2 was significantly lower than the control group（9.68% vs 31.48%, χ~2=8.63）, the differences were statistically significant（P〈0.05）. The incidence of complications in the observation group within 7 days after surgery was lower than that in the control group（9.68% vs 20.37%）, but the difference was not statistically significant（χ~2=2.64, P =0.10）. Conclusion Compared with nasal packing method, nasal septum suture is more effective in treatment of nasal septum deviation in nasal septum angioplasty. It can significantly improve postoperative headache, nose swelling, tearing and nasal congestion, and nasal mucosa edema. It is worthy of promotion and application.