功能性鼻内镜鼻窦术后纳吸棉填塞止血对患者舒适度和术腔恢复效果的影响
| 作者: |
1赵昕,
1单楠楠
1 安徽皖北煤电集团总医院耳鼻喉科，安徽 宿州 234000 |
| 通讯: |
赵昕
Email: 106976612@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.04.014 |
摘要
目的：探讨功能性鼻内镜鼻窦术(functional endoscopic sinus surgery，FESS)后纳吸棉填塞止血对患者舒适度和术腔恢复效果的影响。方法：前瞻性选取2017年7月至2020年5月期间在皖北煤电集团总医院耳鼻咽喉科接受FESS的90例慢性鼻-鼻窦炎(chronic rhinosinusitis，CRS)患者，采用随机数表法分为纳吸棉组(n=45)和明胶海绵组(n=45)；纳吸棉组FESS术后采用纳吸棉填塞术腔止血，明胶海绵组采用明胶海绵填塞术腔止血，术后随访3个月。观察两组止血和鼻腔症状缓解情况，采用视觉模拟疼痛量表(Visual Analogue Scale，VAS)评分评估患者舒适度，利用鼻内镜检查Lund-Kennedy评分和测量鼻腔气道阻力观察术腔恢复效果。结果：两组均充分止血，术腔术后未出现活动性出血，纳吸棉组术后4周鼻阻塞、鼻痛症状程度明显轻于明胶海绵组(P<0.05)；纳吸棉组术后2、4周VAS评分显著低于明胶海绵组，术后4周、3个月鼻内镜Lund-Kennedy评分均低于明胶海绵组，差异均有统计学意义(P<0.05)；纳吸棉组术后第1次鼻腔气道阻力显著低于明胶海绵组(P<0.05)。结论：纳吸棉是CRS患者FESS术后理想的鼻腔填塞止血材料，在缓解术腔相关症状、减轻疼痛、促进术腔恢复和改善鼻腔通气方面效果显著。
关键词：
慢性鼻-鼻窦炎；功能性鼻内镜鼻窦术；鼻腔填塞；可吸收止血材料；舒适度；鼻腔气道阻力
Effect of cotton tamponade hemostasis after functional endoscopic sinus surgery on patients’ comfort and recovery of operation cavity
CorrespondingAuthor: ZHAO Xin Email: 106976612@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.04.014
Abstract
Objective: To investigate the effect of suction cotton packing hemostasis after functional endoscopic sinus surgery (FESS) on patients’ comfort and the effect of cavity recovery. Methods: Ninety patients with chronic rhinosinusitis (CRS) who received FESS at Department of Otolaryngology of Wanbei Coal and Power Group General Hospital from July 2017 to May 2020 were prospectively selected and randomly divided into an absorbent cotton group (n=45) and a gelatin sponge group (n=45). After FESS, the absorbent cotton group aimed to stop bleeding of the operation cavity with absorbent cotton, suction cotton, while the gelatin sponge group was treated with gelatin sponge. The patients were followed up for 3 months. We observed the hemostasis and nasal symptom relieved of the two groups, and adopted the scores of the Visual Analogue Scale (VAS) to evaluate the comfort of patients. Besides, the Lund-Kennedy score and nasal airway resistance were measured by nasal endoscopy to observe the recovery of surgical cavity. Results: With adequate hemostasis, there was no active bleeding in the two groups, and the symptoms of nasal obstruction and nasal pain in the absorbent cotton group was more significantly relieved than that in the gelatin sponge group at 4 weeks after operation (P<0.05). Furthermore, the VAS scores of the absorbent cotton group were significantly lower than those of the gelatin sponge group at 2 and 4 weeks after operation, but the Lund Kennedy scores of nasal endoscopy at 4 weeks and 3 months after operation were significantly lower than those of the gelatin sponge group, which were statistically significant (P<0.05). Additionally, the first nasal airway resistance in the absorbent cotton group was significantly smaller than that in the gelatin sponge group (P<0.05). Conclusion: Absorbent cotton is an ideal hemostatic material for nasal packing in patients with CRS after FESS. It has significant effect on relieving the symptoms of CRS, relieving pain, promoting the recovery of operation cavity and improving nasal ventilation.
Keywords：
chronic rhinosinusitis; functional endoscopic sinus surgery; nasal packing; absorbable hemostatic materials; comfort; nasal airway resistance