聚乙烯醇止血海绵应用于鼻内镜鼻窦手术中的疗效观察

目的 探讨聚乙烯醇止血海绵填塞在鼻内镜鼻窦手术后的效果.方法 收集耳鼻喉科行鼻内镜鼻窦手术治疗的患者共90例,随机分为两组,治疗组45例术后采用聚乙烯醇止血海绵填塞,对照组45例应用碘仿纱条填塞,观察两组患者的手术时间、填充后渗血量、术后反应、填塞物拔出后出血量以及术口愈合情况方面的差异.结果 观察组术口愈合44例,愈合率为97.78%,对照组愈合32例,愈合率为71.11%,观察组术后愈合率高于对照组（P＜0.01）,填塞材料对观察组的影响（有眼部症状、进食有影响）较对照组轻（P＜0.05或＜0.01）.观察组患者的手术时间短于对照组,填充后渗血量、拔出后出血量少于对照组（P＜0.01）.观察组患者的术后疼痛程度显著轻于对照组（P＜0.01）.结论 鼻内镜鼻窦手术后应用聚乙烯醇止血海绵填塞,操作简单,可减少手术时间和填充后渗血,术后反应轻,拔出后出血少,术口愈合好,是一种良好的鼻内镜鼻窦手术填充材料.

Observation of the clinical effect of polyvinyl alcohol hemostatic sponge in nasal endoscopic sinus surgery

Objective To investigate the effect of polyvinyl alcohol hemostatic sponge in nasal endoscopic sinus surgery.Methods 90 patients undergoing nasal endoscopic sinus surgery were selected and randomly divided into two groups with 45 cases in each group. Polyvinyl alcohol hemostatic sponges were applied to the treatment group after operation,while the control group used iodoform of bleeding after filling, the postoperative reaction, bleeding amount after the pullout of fillers and the healing of postoperative wound between the two groups were observed.Results 44 cases in the observation group got wounds healed after the operation with a healing rate of 97.78 %, while only 32 cases in the control group got wounds healed after the operation with a healing rate of 71.11%. The data showed that the healing rate of the observation group was significantly higher than that of the control group（ P 〈0.05 or 〈0.01）. Blinding material had less effect （including effect on ocular symptoms and eating）on the observation group than they did on the control group（ P ~O.01）.In the observation group,the operation time was shorter than that in the control group.Their bleeding amount after operation and bleeding volume after the pullout of tamponade were also.less than those in the control group（ P〈0.01）.Besides, patients in the observation group had slighter pain degree after operation（ P〈0.01）.Conelusion Applying polyvinyl alcohol hemostatic sponge in nasal endoscopic sinus surgery is easy to operate.It can shorten the operation time and reduce bleeding after filling. Hemostatic sponge causes light postoperative reactions and less bleeding after being pulled out and makes postoperative wounds heal very soon,so it is a kind of good filling material in nasal endoscopic sinus surgery.