微创鼻中隔矫正导尿管负压吸引不填塞鼻腔的临床应用

目的探讨鼻中隔矫正术后不填塞鼻腔的可行性。方法选择53例单纯鼻中隔偏曲患者，在鼻内镜下行鼻中隔矫正，对46例双侧黏骨膜无损伤或位于前部的能缝合小裂伤患者，术后不填塞鼻腔、术腔置导尿管持续负压吸引。结果46例患者中，术后3d出血量为（8．1±5．6）ml，33例术后3d的水肿程度较轻，下鼻甲与鼻中隔间距适中，鼻腔通气良好；其中13例术后24h鼻黏膜反应性水肿较重（5例为变应性鼻炎），应用呋麻滴鼻液及激素喷鼻后鼻黏膜收缩敏感，通气良好，3d后拔管直到一期愈合。所有病例均达治愈，未发生鼻中隔血肿，随访半年以上，无并发症。结论鼻中隔矫正术后，只要双侧黏骨膜无裂伤，术腔置导尿管持续负压吸引，不填塞鼻腔是可行的。

The usage of continuous suction through catheter in the surgery of endoscopic correction of nasal septum without nasal packing

Objective To explore the feasibility of non-nasal packing after correction of nasal septum. Methods 53 cases of simple deviation of nasal septum were underwent endoscopic correction of nasal septum.The continuous suction in surgical cavity through catheter without nasal packing after surgery was applied to 46 cases with intact double-mucosa or little wound that could be sutured in front of nasal septum. Results Of the 46 patients,the volume of the bleeding 3 days after the operation were(8.1 ± 5.6)ml.The degree of the nasal mucosa edema in 33 patients were lightened than others,the space between the inferior nasal concha and the nasal septum were fine as well as the ventilation of the nasal cavity.Among those cases,there were 13 patients with severe nasal mucosa edema(5 cases were allergic rhinitis)which were treated with ephedrine and furaciline solution or glucocorticoid,as the results,the nasal mucosa shrinked,and the patients could respire well.The catheter were extracted 3 days after the operation until the primary healing.All the cases were healing well without the the nasal septum hematoma and other complications which were follow up more than half a year. Conclusion The method of continuous suction in surgical cavity through catheter without nasal packing was feasible if double nasal septum mucosa was intact after correction of nasal septum.