鼻内镜下鼻中隔矫正术后血肿的预防

Effective preventive measures of postoperative hematoma formation after nasal endoscopic septoplasty

摘要:

目的探讨预防鼻内镜下鼻中隔矫正术后鼻中隔血肿的有效方法。方法回顾性分析安徽医科大学第一附属医院2016年1月—2019年4月收治的行鼻内镜下鼻中隔矫正术的220例患者的临床资料。其中90例患者鼻中隔矫正术后鼻中隔两侧黏膜完整为甲组；90例患者术后黏膜完整，行一侧近鼻底处鼻中隔黏膜水平贯穿切开，长约1 cm，本研究称之为黏膜辅助切口为乙组；40例患者术后一侧或两侧鼻中隔黏膜有不对称破损为丙组。术后3组均予膨胀海绵填塞。结果甲组患者出现鼻中隔血肿5例，乙组和丙组患者皆未出现鼻中隔血肿,所有患者均无鼻中隔穿孔。3组之间的鼻中隔血肿发生率差异具有统计学意义(χ2=9.107，P<0.05)。结论对于术后两侧鼻中隔黏膜完整的患者,鼻中隔矫正后行一侧鼻中隔黏膜切开能有效预防鼻中隔术后鼻中隔血肿的发生。

Abstract:

ObjectiveTo investigate an effective method for prevention of septal hematoma after nasal endoscopic correction of nasal septum.MethodsClinic data of 220 patients admitted to the first affiliated hospital of anhui medical university was analyzed retrospectively. The patients underwent an endoscopic septoplasty under nasal endoscopy from January 2016 to April 2019. Ninety cases of the 220 patients had intact mucosa on both sides of the nasal septum after nasal septum correction, who were defined as group A; The incisions of the septum mucosa in 90 patients with intact mucosa postoperation were cut for 1 cm at the proximal nasal base named as a mucosal assisted incision. And the 90 patients were defined as group B. Forty patients had an asymmetry broken in the nasal septum mucosa on one or both sides after surgery, which was defined as group C. All patients of the 3 groups were filled with expanded sponge.ResultsThere were septal hematoma in 5 cases of group A. No septal hematoma occurred in all patients of group B or group C. No nasal septum perforation was found in all cases. There was a statistically significant difference in the incidence of septal hematoma between the three groups (P<0.05).ConclusionThe patients with intact nasal septum mucosa on both sides after operation, the septal mucosal incision of one side after septoplasty can effectively prevent the occurrence of nasal septum hematoma .