慢性鼻窦炎鼻内镜术后无鼻腔填塞的可行性研究

目的 比较慢性鼻窦炎鼻内镜术后无鼻腔填塞与填塞的疗效,探讨术后无鼻腔填塞的可行性.方法 将82例1,2型慢性鼻窦炎患者按随机数字表法分为无填塞组（44例,75侧）和填塞组（38例,65侧）,两组患者均采取术前抗炎、降压等治疗,在全身麻醉下手术.比较两组出血量、术后疼痛程度（采用视觉模拟评分,VAS）、黏膜水肿程度、疗效、术后并发症等.结果 两组出血量、疗效比较差异无统计学意义（P＞0.05）.无填塞组术后VAS明显低于填塞组（2.46±0.54）分比（5.49±1.26）分],差异有统计学意义（P＜0.01）.无填塞组与填塞组术后1周、术后6个月黏膜水肿评分比较差异无统计学意义（P＞0.05）,但无填塞组术后1个月黏膜水肿评分明显低于填塞组（1.32±0.63）分比（3.52±0.72）分],差异有统计学意义（P＜0.01）.填塞组患者术后并发症较无填塞组明显增加.结论 对1,2型慢性鼻窦炎患者全身麻醉下行鼻内镜手术无明显出血时,可以不行鼻腔填塞,且有利于减轻患者的痛苦及减少术后并发症的发生.

Feasibility study of no nasal packing after endoscopic sinus surgery for chronic sinusitis

Objective To compare the efficacies between nasal packing and no nasal packing after endoscopic sinus surgery for chronic sinusitis,and explore the feasibility of no nasal packing after endoscopic sinus surgery.Methods Eighty-two type 1 or type 2 chronic sinusitis patients who received endoscopic sinus surgery under general anesthesia were divided into no nasal packing group （44 cases,75 sides） and nasal packing group （38 cases,65 sides） by random digits table method.The patients in 2 groups were taken preoperative anti-inflammatory and regulation blood pressure treatment.The volume of bleeding,postoperative pain （visual analogue score,VAS）,degree of mucosal edema,efficacy and postoperative complications between 2 groups were compared.Results There were no statistical difference in volume of bleeding and efficacy between 2 groups （P 〉 0.05）.The postoperative VAS in no nasal packing group was significantly lower than that in nasal packing group （2.46 ± 0.54） scores vs.（5.49 ± 1.26） scores],there was statistical difference （P〈 0.01）.There was no statistical difference in mucosal edema score postoperative 1 week and 6 months between 2 groups （P 〉 0.05）,but the mucosal edema score postoperative 1 month in no nasal packing group was significantly lower than that in nasal packing group （1.32 ±0.63） scores vs.（3.52 ±0.72） scores],there was statistical difference （P 〈 0.01）.Postoperative comphcations in nasal packing group were significantly more than those in no packing group.Conclusion No nasal packing can be performed for type 1 or type 2 chronic sinusitis patients who has no significant bleeding after endoscopic sinus surgery under general anesthesia,it is actually beneficial of relieving distress of the patient and reducing postoperative complications.