改良鼻中隔贯穿缝合与鼻腔填塞在鼻中隔偏曲矫正术中疗效观察

Comparison of the Efficacy of Modified Nasal Septum Suture and Nasal Packing in the Correction of Nasal Septum Deviation

目的:比较鼻中隔偏曲矫正术后常规填塞和贯穿缝合2种方法的疗效,寻求减轻患者术后不适的术式。方法:选取60例行鼻中隔偏曲矫正术的患者为研究对象,30例常规总鼻道填塞为填塞组,30例行鼻中隔贯穿缝合为缝合组。比较2组患者术后视觉模拟量表(VAS)评分、黏膜恢复、鼻腔吸气/呼气总阻力等指标。结果:术后填塞期间填塞组鼻部疼痛、头痛、溢泪、吞咽困难VAS评分大于缝合组,差异有统计学意义(P<0.05);取出填塞物后2组VAS评分差异无统计学意义(P>0.05);术后2组患者黏膜均有不同程度损伤、肿胀、淤血及纤维渗出,但缝合组程度轻,恢复时间更短;缝合组鼻腔粘连发生率3.3%低于填塞组的6.7%,差异无统计学意义(P>0.05),未发生鼻出血、鼻中隔穿孔、血肿、局部感染等并发症;术后1个月2组鼻腔吸气/呼气总阻力差异无统计学意义(P>0.05)。结论:鼻中隔缝合的矫正效果与鼻腔填塞相当,但能显著减轻患者术后主观不适感,且鼻腔功能恢复迅速。

Objective:To compare the two methods of conventional packing and modified nasal septum suture after nasal sep-tum correction,and to seek a method to reduce the discomfort of patients after operation.Methods:According to the principle of voluntary selection,60 patients with nasal septum deviation correction were divided into the packing group and the suture group.In the packing group,30 patients underwent conventional tamponade.In the suture group,30 patients received modified nasal septum sutures after nasal septum deviation correction without nasal packing.Postoperative nasal pain,headache,epiphora,dysphagia,and sleep difficulty were compared between the two groups.total nasal inspiratory/expiratory resistance,the recovery of the mucosa,fiber exudation,epistaxis,septum hematoma,perforation,adhesion,and local infection between the two groups were recorded and compared during postoperative follow-up.Result:The mean VAS score of the packing group was higher than that of the suture group for postoperative nasal pain,headache,tears,dysphagia,and sleep difficulty(P<0.05).There was no significant difference in to-tal nasal inspiratory/expiratory resistance between the two groups one month after operation(P>0.05).Postoperative observation of mucosal injury,swelling,congestion,and fiber exudation showed that the suture group was significantly better than the packing group,and the mucosal recovery time was shorter.There was 1 case(3.3%)of nasal adhesion in the suture group and 2 cases(6.7%)in the packing group,the difference was not statistically significant(P>0.05);no complications such as epistaxis,perfo-ration of nasal septum,hematoma and local infection occurred.Conclusion:The modified nasal septum suture technique is effective and safe,which makes it possible not to pack after correction of nasal septum deviation.