鼻中隔矫正术后鼻腔微创支架与膨胀海绵填塞的临床对照研究

Comparative study of nasal stent and Merocel® sponge as nasal pack after septoplasty

摘要:

目的 通过对比观察鼻腔支架与膨胀海绵应用于鼻中隔矫正术后填塞的临床效果及舒适度，分析鼻腔支架临床应用的安全性及有效性。方法 选择因鼻中隔偏曲行鼻中隔偏曲矫正术患者56例，按填塞方式随机分为鼻腔支架组（实验组26例）和膨胀海绵组（对照组30例），比较两组填塞期止血效果、舒适度及并发症情况。结果 实验组有效率69%，对照组有效率60%，差异无统计学意义（χ²=0.517，P=0.472），术后视觉模拟量表（VAS）评分均值显示实验组鼻塞、鼻痛、头痛、溢泪、面部胀痛、吞咽困难、睡眠障碍、口干及总体不适均小于对照组，差异具有统计学意义（P<0.05）。实验组及对照组患者均未出现鼻中隔穿孔、鼻中隔血肿及感染等并发症。结论 鼻腔支架作为鼻中隔矫正术后新型填塞方式安全有效，舒适度优于膨胀海绵填塞，可进一步应用于临床。

Abstract:

Objective To investigate the safety and effectiveness of nasal stent as nasal pack after septoplasty by comparing the clinical effect and comfort level of nasal stent and Merocel^® sponge applied in septoplasty.Methods A total of 56 patients undergoing septoplasty due to nasal septal deviation were selected and randomly divided into nasal stent group (experimental group, n=26) and Merocel^® sponge group (control group, n=30) according to the packing method. The hemostasis effect, comfort level and complications during the packing period between the two groups were compared.Results The effective rate of the experimental group was 69%, and that of the control group was 60%, the difference was statistically insignificant (χ²=0.517, P=0.472). The mean visual analogue scale (VAS) scores of nasal obstruction, rhinalgia, headache, epiphora, facial pain and compression, dysphagia, sleep disorder, dry mouth as well as general discomfort in the experimental group were all lower than those of the control group (all P<0.05). Septal perforation, septal hematoma and infection were found in neither of both groups.Conclusion Nasal stent is safe and effective as a new packing method after nasal septal correction. It is preferred over Merocel^® sponge in comfort level, and can be further applied in clinical practice.