改良鼻中隔缝合填塞法在鼻中隔矫正术中的应用

Application of modified nasal septum suture and packing method in nasal septum correction

目的:评价改良鼻中隔缝合法及填塞可吸收材料在鼻中隔偏曲矫正术中的临床疗效。方法:将40例鼻中隔偏曲患者随机分为传统填塞组(20例)和改良缝合填塞组(20例)。比较两组患者术后24 h主观不适症状的视觉模拟量表(VAS)评分、术后48 h鼻部处理时鼻痛VAS评分、术后6个月并发症的发生率。结果:改良缝合填塞组术后24 h在鼻塞、鼻胀痛、头胀痛、流泪、耳闷或耳鸣、吞咽困难、睡眠障碍方面不适症状评分均低于传统填塞组,差异均有统计学意义(P<0.001);传统填塞组术后48 h痛苦评分高于改良缝合填塞组,差异有统计学意义(P<0.001);术后随访传统填塞组出现1例鼻粘连、1例血肿、2例鼻腔干燥,改良缝合填塞组未出现粘连、血肿及鼻腔干燥,随访6个月,两组患者均未出现明显术后并发症。结论:改良鼻中隔缝合填塞法在鼻中隔矫正术中操作简便,可改善患者术后填塞痛苦,减少术后并发症,值得临床推广。

Objective:To evaluate the clinical effect of modified nasal septum suture and packing with absorbable materials in the correction of nasal septum deviation.Methods:Forty patients with deviation of nasal septum were randomized to conventional packing group(n=20)and modified suture packing group(n=20).Then the two groups were compared regarding VAS scoring on subjective discomfort symptoms at 24-hour after operation,postoperative VAS scores of nasal pain at 48-hour and incidence of postoperative complications half a year after surgery.Results:The scores of discomfort symptoms,including nasal congestion,nasal distension,headache,tearing,ear tightness or tinnitus,dysphagia,and sleep disorders,were significantly lower in the modified suture packing group than in the conventional packing group at 24 hour after surgery(P<0.001).The pain score at 48-hour after surgery in the conventional packing group was significantly higher than that in the modified suture packing group(P<0.001).Nasal adhesion(n=1),hematoma(n=1)and dry nasal cavity(n=2)were seen in the conventional tamponade group in the follow-up after surgery,yet such complications were not seen in the modified suture packing group.Half a year of follow-up showed no obvious postoperative complications in the two groups.Conclusion:The modified nasal septum suture and tamponade method is simple and convenient to operate in the correction of nasal septum,and worthy of clinical recommendation,for this approach can significantly improve the postoperative pain of the patients from tamponade and reduce postoperative complications,especially for patients with nasal stenosis.