膨胀海绵后鼻孔填塞在局部麻醉鼻内镜手术中的应用

The application of postnasal packing with Merocel in endoscopic sinus surgery under local anesthesia

目的:探讨局部麻醉鼻内镜手术中后鼻孔膨胀海绵填塞的应用效果。方法:将75例前组鼻窦炎局部麻醉手术患者分为A,B,C三组,每组25例。A组术中用膨胀海绵填塞后鼻孔,B组术中用凡士林纱条填塞后鼻孔,C组术中未行填塞。比较术中口腔血性分泌物清理次数及患者自觉不适的程度。结果:A组与B组清理次数比较,差异无统计学意义(P>0.05),A组、B组清理次数均少于C组,差异均有统计学意义(P<0.001)。主观不适感视觉模拟量表(VAS)评分A组与B组、A组与C组比较,差异均有统计学意义(P<0.001),但B组和C组比较,差异无统计学意义(P>0.05)。结论:术中后鼻孔膨胀海绵填塞有利于局部麻醉鼻内镜手术顺利进行,避免血性分泌物流入口腔,提高局部麻醉手术成功率和患者的顺应性。

Objective:To evaluate the application of postnasal packing with merocel in endoscopic sinus surgery under local anesthesia.Methods:A total of 75 patients with anterior rhinosinusitis who received endoscopic sinus surgery under local anesthesia,were randomly divided into 3 groups:25 patients in group A were packed with merocel in postnasal,25 patients in group B were packed with vaseline strip in postnasal,there were 25 patients in group C,which was non-packed group.The cleaning times of oral bloody secretions and the degree of discomfort were compared among the three groups.Results:There was no significant difference in cleaning times between Group A and group B(P>0.05).The cleaning times of Group A and Group B were less than that of Group C(P<0.001).There were significant differences in visual analogue scale(VAS)scores between Group A and Group B,Group A and group C(P<0.001),but there were significant differences between Group B and Group C,there was no significant difference(P>0.05).Conclusion:Postnasal packing with merocel is beneficial to the successful operation of endoscopic sinus surgery under local anesthesia,avoid bloody secretions flowing into the oral,improve the success rate of local anesthesia surgery and patient compliance.