鼻腔填塞物的选择及疗效比较

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(Gel Knit,31例)四种材料填塞鼻腔,24h～48h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%;Gel Knit组3.2%,四组比较差异非常显著(χ2=70.21,P<0.01)。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,P<0.01)。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。

Effect Comparison of Nasal Packing Material

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 Gel-Knit 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 Gel-Knit.The significant statistical difference was observedbetween the four groups (χ2=70.21,P<0.01).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,P<0.01).Conclusions The choosing of postoperative na-sal packing after functional endoscopic sinus sur-gey(FESS) depends on various factors,Gel-Knit has much advantages and can be used as routine packs after FESS.