鼻腔填塞物的选择及疗效比较.DOCVIP

临床医学论文-鼻腔填塞物的选择及疗效比较 【关键词】? 内镜鼻窦手术;鼻腔填塞;止血材料 　　［摘? 要］ 目的：比较四种鼻腔填塞材料的疗效，指导临床选择合适的术后鼻内填塞物。方法:对134例慢性鼻窦炎分别采用凡士林纱条(40例)、藻酸钙纤维(Sorbalgon,27例)、膨胀海绵(Merocel,36例)和瑞纳凝胶快速止血材料(GelKnit,31例)四种材料填塞鼻腔,24 h～48 ｈ取出填塞物,根据填塞后鼻腔胀痛、头痛程度,取出填塞物后鼻腔出血程度等评价疗效。结果:凡士林纱条填塞组,82.5%有鼻腔胀痛或头痛；Sorbalgon藻酸钙纤维组11.1%；Merocel组44.4%；GelKnit组3.2%，四组比较差异非常显著(χ2=70.21,Ｐ0.01)。取出填塞物后鼻腔再出血分别为85%,11.1%,41.7%和9.7%,四组比较差异非常显著(χ2=54.28，Ｐ0.01)。结论: 鼻内镜手术时，应综合考虑诸方面因素合理选用术后填塞物。瑞纳优势较为全面，可作为鼻内镜手术的常规填塞材料。 　　［关键词］ 内镜鼻窦手术;鼻腔填塞;止血材料 　　Effect Comparison of Nasal Packing Material 　　Abstract:Objective To compare four postoperative nasal packing materials.Methods Total 136 patients,80 cases with chronic sinus it is and under went endoscopic sinussurgery,were randomly packed using four different hae mostasis materials.In which,paraffin gauze group was 40 cases,rapid Sorbalgon group 27 cases,Merocel group 36 cases and GelKnit group 31 cases.The packing materials wereemoved after left for 24 hours to 48 hours.The efficacy of nasal packing materials was asassessed interm of the levels of nasal pain or headache in the leaving period and nasal bleeding after removal of nasal packing.Results the in cidence rate of nasal pain or headache respectively was 82.5% in paraffin gauze group,44.4% in Merocel,11.1% in sorbalgon and 3.2% in GelKnit.The significant statistical difference was observedbetween the four groups (χ2=70.21，Ｐ0.01).The incidence rate of nasal bleeding after removed was 85%,11.1%,41.7% and 9.7% respectively.The statistical difference was also significant (χ2=54.28，Ｐ0.01).Conclusions The choosing of postoperative nasal packing after functional endoscopic sinus surgey(FESS) depends on various factors,GelKnit has much advantages and can be used as routine packs after FESS. 　　Key words:Endoscopic sinus surgery;Nasal packing;Hemostasis material ??? 功能性鼻内镜鼻窦手术（FESS）现已成为治疗慢性鼻窦炎鼻息肉的常规手术。恰当选择和使用鼻内填塞物已经成为鼻内镜手术技术不可分割的重要组成部分，过去,术后鼻腔填塞都使用碘仿纱条或凡士林纱条，其只起到机械压迫作用,但却存在头痛、鼻部肿痛和鼻腔不通气等弊端,增加了患者的痛苦。近年,随着生物材料和技术的不断创新和进步,推出了多种新的各具特色的鼻腔填塞材料,可有效止血并兼