探讨功能性鼻内镜鼻窦术后鼻腔填塞指征及对患者舒适度的影响

To explore the indication of nasal packing after functional endoscopic sinus surgery and its influence on patients'comfort

目的探讨功能性鼻内镜鼻窦术后鼻腔填塞的必要性及指征和对患者术后舒适度的影响。方法选取2020年01月-2020年06月在烟台市某三甲医院进行的128例功能性鼻内镜鼻窦手术(Functional Endoscopic Sinus Surgery,FESS)患者,分别从人口统计学特征、病史、疾病程度、手术程序以及术中出血的主客观因素进行评估,同时结合术后症状和内窥镜检查结果。结果 192例FESS患者术后未进行鼻腔填塞,未填塞组(no-packing group,NPG)较填塞组(packing group,PG)术后第1天鼻塞和鼻后滴漏症状评分较低;在单侧FESS病例中,未填塞组主观估计的失血量和粘膜炎症评分较低(P<0.05),其他参数两组比较无明显统计学差异。结论 FESS术后鼻腔填塞的指征受手术期间程序操作和术者主观评价等因素决定且在手术结果允许的情况下,FESS术后鼻腔尽量减少或不填塞,对患者术后舒适度以及疾病转归具有积极意义。

Objective To explore the necessity and indication of nasal packing after functional endoscopic sinus surgery and its influence on postoperative comfort.Methods 128 patients undergoing functional endoscopic sinus surgery in a hospital in Yantai from January 2020 to June 2020 were evaluated from demographic characteristics,medical history,disease degree,surgical procedure and subjective and objective factors of intraoperative bleeding,combined with postoperative symptoms and endoscopy results.Reshlts 192 patients with FESS did not have nasal packing after operation,and no-packing group(NPG)scored lower than packing group(PG)on the first day after operation.In unilateral ESS cases,the blood loss and mucosal inflammation score in the non-tamponade group were lower(P<0.05),and there was no significant difference in other parameters between the two groups.Conclusions The indication of nasal packing after functional endoscopic sinus surgery is determined by the factors such as procedure operation during the operation and subjective evaluation of the operator.If the operation Results permit,the nasal packing should be reduced or not as much as possible after functional endoscopic sinus surgery,which is of positive significance to patients'postoperative comfort and disease outcome.