改良鼻内镜下鼻中隔成形术及三种术式比较

目的对鼻内镜下改良鼻中隔成形术及两种传统术式的利弊和适应证进行临床评价。方法回顾性分析342例接受手术的患者,按手术方式分为鼻内镜下改良鼻中隔成形术组(简称A组)、鼻中隔黏膜下切除术组(简称B组)、鼻中隔黏膜下矫正术组(简称C组),观察各组患者的鼻中隔病变、症状消失率、伤口出血、肿胀、疼痛、愈合情况及术后并发症。结果三组症状消失率与伴随症状痊愈率比较无统计学意义(P>0.05);在切口观察指标中,A组与B组、C组间比较有统计学意义(P<0.01);B组与C组比较,除术中出血无统计学意义外,局部肿胀、疼痛、伤口愈合的比较有统计学意义(P<0.01)。结论鼻内镜下改良鼻中隔成形术及外斜“L”形切口目的明确、视野广、创伤小、愈合好、并发症少、疗效确切。

Modified septorhinoplasty via nasal endoscope and comparison of three surgical methods for nasal septum

Objective To evaluate indications,advantages and disadvantages of the modified septorhinoplasty via endoscope and other two traditional surgical methods for nasal septum.Methods 342 patients suffering from nasal septum deviation were randomly divided into 3 groups: modified septorhinoplasty via nasal endoscope(group A),submucous resection(group B),and submucous diorthosis(group C).The surgical effect,bleeding during operation,postoperative pain,swelling and healing of incision,operative complications were analyzed retrospectively.Results The differences of surgical effect among the 3 groups were insignificant(P>0.05),while the differences of incision indices were significant(P<0.01) when group A was compared with group B and group C,and those of group B except bleeding during operation were significant(P<0.01) compared with group C.Conclusion Owing to the definite objective and wide vision field,the modified septorhinoplasty via nasal endoscope and the submucous resection of nasal septum through an oblique L-shaped incision usually do mild tissue damage,slight postoperative reaction,and well healing of incision.