个体化减张整形术与传统黏膜下切除术治疗鼻中隔偏曲的比较研究

目的 比较鼻中隔支架的个体化减张整形矫正术与传统黏膜下切除术治疗鼻中隔偏曲的效果。方法 采用病例对照的研究方法回顾分析2009年至2013年收治的鼻中隔偏曲160例的临床资料, 按病变部位及类型相似、年龄相差≤5岁, 1:1配对。随访12个月以上, 比较两组手术时间、术中出血量、术后鼻中隔血肿、术后疼痛、活瓣性鼻塞及原鼻塞症状改善情况。结果 研究组和对照组各纳入80例患者, 研究组手术时间为20～60(37.48±10.78)min, 对照组为20～55(34.66±10.86)min, 差异无统计学意义(t=1.644, P > 0.05);研究组术中出血量为3～15(9.38±3.02)mL, 对照组为5～20(11.59±4.71)mL, 研究组少于对照组(t;=-3.536, P < 0.01);两组术后疼痛以中等疼痛为主, 第1天最重, 研究组为2～6(4.59±0.82)分, 对照组为3～7 (4.95±0.86)分(t=-2.733, P < 0.01);第2天研究组为1～5(2.93±0.65)分, 对照组为2～5 (3.43±0.71)分(t=-4.649, P < 0.01), 差异均有统计学意义;第3天开始症状趋于平缓, 研究组为1～2(1.55±0.50)分, 对照组为1～3(1.69±0.52)分, 差异无统计学意义(t=-1.707, P > 0.05)。术后并发症：研究组有1例鼻中隔血肿(1/80), 对照组出现5例(χ²=1.558 4, P > 0.05),差异无统计学意义;研究组无术后活瓣性鼻塞, 对照组随访中出现6例(6/80), 差异有统计学意义(χ²=4.329, P < 0.05);研究组鼻塞症状均消失, 对照组随访中发现轻度鼻塞6例(6/80), 差异有统计学意义(χ²=4.329, P < 0.05)。结论 与传统黏膜下切除术相比, 个体化减张整形矫正术未明显延长手术时间, 术中出血较少, 术后疼痛较轻, 并发症较少。

A comparative study on effect of the individual tension relaxing plasty versus traditional submucosal resection for deviation of the nasal septum.

Objective To compare the effect of nasal septum support individual tension relaxing plasty with traditional submucousal resection for nasal septum deviation. Methods A case-control study was made on patients with deviation of nasal septum treated in our department during 2009 to 2013. Based on the lesion site, similar type and age difference of less than 5 years, 80 patients in the study group and 80 in the control group were one to one matched in this study. Followed up over 12 months, the operation time, intra-operative bleeding, post-operative nasal septal hematoma, post-operative pain, stuffy nose and nasal valve of the original symptom improvement were compared. Results The operation time was 20-60 (37.48±10.78) minutes in the study group and 20-55(34.66±10.86) minutes in the control group (t=1.644, P>0.05). The intra-operative bleeding was 3-15(9.38±3.02) mL in the study group and 5-20 (11.59±4.71) mL in the control group (t=-3.536, P<0.01). The post-operative pain was moderate in the two groups and it was the most on the first day 2-6 (4.59±0.82) points in the study group and 3-7 (4.95±0.86) points in the control group (t=-2.733, P<0.01), on the second day 1-5 (2.93±0.65) points in the study group and 2-5 (3.43±0.71) points in the control group (t=-4.649, P<0.01), on the third day 1-2 (1.55±0.50) points in the study group and 1-3 (1.69±0.52) points in the control group (t=-1.707, P>0.05). Post-operative complications: nasal septum hematoma, 1 case in the study group (1/80) while 5 in the control group (χ²=1.558 4, P>0.05); valvular nasal obstruction, none in the study group while 6 (6/80) in the control group (χ²=4.329, P<0.05); nasal obstruction, none in the study group while 6 in the control group (χ²=4.329, P<0.05). Conclusion Compared with traditional submucosal resection, individual tension plastic correction has advantages of less intra-operative bleeding and post-operative pain and fewer complications in the deviation of nasal septum treatment.