凡士林纱条鼻腔填塞和抽取两种方法的疗效比较

目的 探讨鼻腔术后凡士林纱条填塞及抽出更理想的方法.方法 349例鼻腔术后患者(慢性肥厚性鼻炎265例,行双侧下鼻甲部分切除术的患者203例,行中下鼻甲部分切除术患者62例;鼻息肉摘除、筛窦开放术患者46例;鼻中隔矫正术患者38例)随机分为两组,A组181例采用"层叠式"方法鼻腔填塞并分次抽取,B组168例采用传统的"口袋式"方法鼻腔填塞及抽取.结果 两组止血效果无差异,有效率均为100%;抽取纱条过程中出血少于5 ml及20 ml A组发生率分别为94.48%、100%,B组分别为9.52%、2.34%,差异有显著性意义(P＜0.01);填塞后给患者造成的痛苦不适(鼻塞、头痛、鼻胀痛,影响进食、睡眠)前者明显轻于后者;愈合平均时间前者比后者少3.1 d,差异有显著性意义(P＜0.01).结论 "层叠式"鼻腔填塞及分次抽出方法,止血有效,痛苦小,出血少,对伤口愈合影响小,值得推广应用.

Effects Comparison of two kind of Nasal Packing and Drawing Methods with Vaseline Gauze

Objective To compare the methods of nasal packing and drawing.Methods Total 349 patients,265 case with chronic hypertrophic rhinitis and 203 case underwent two partial inferior turbinectomy and 62 case underwent partial inferior and middle turbinectomy,46 case with na- sal polyps and chronic sinusitis and underwent nasal polypectomy and transnasal ethmoidecto- my,38 case with deviation of nasal septum and underwent septoplasty,all case packing mate- rials were vaseline gauze and devided into two group,In which,A group 181 case with meth- ods of conventional cascade pattern of nasal packing and unpacking,B group 168 case with the improved method of placket pattern of nasal packing and unpcking.Results The effective rate of hemostasis was 100% in A group,100% in B group,the incidence rate of nasal bleed- ing in drawing vaseline gauze less than 5 ml and 20 ml was 94.48%,100% in A group,9.52%, 25.60% in B group.Discomfort which came from nasal packing ( e.g.nasal obstruction,nasal pain,headache et.)in A group was less than B group.Conclusion The improved method of placket pattern of nasal packing and drawing has much advantages and can be used as routine methods after sinonasal surgery.