Weber R, Hochapfel F, Draf W
Department of Otorhinolaryngology, Head, Neck and Facial Plastic Surgery, Communication Disorders Hospital Fulda, Germany.
Rhinology. 2000 Jun;38(2):49-62.
Nasal packing is used primarily to control bleeding in epistaxis and after surgical procedures to the nose such as septoplasty, turbinate and paranasal sinus surgery. It is also used for internal stabilisation after operations involving the cartilaginous-bony skeleton of the nose. Apart from haemostasis, packing is used to prevent synechiae or restenosis, particularly after surgery. Generally accepted standards regarding the materials which should be used for packing, how long the packing should be left in place or the indications for nasal packing are lacking (Egelund and Jeppessen, 1992; Hosemann, 1996; Weber et al., 1996b). For example, many authors do not use packing at all provided that there is no heavy bleeding during or after the operation. Of those who use packing, some remove it on the day of the operation, others up to 5 days postoperatively (for overview see Weber et al., 1996b). Most publications describe experience with packing materials developed or preferred by the authors. Results of comparative studies on the nature and duration of packing are listed in Table 1. The currently available materials are reviewed and their respective properties, indications and risks are outlined.
鼻腔填塞主要用于控制鼻出血以及在鼻中隔成形术、鼻甲和鼻窦手术等鼻部手术后控制出血。它还用于涉及鼻软骨-骨骨架的手术后的内部稳定。除止血外，填塞还用于预防粘连或再狭窄，尤其是在手术后。目前缺乏关于应使用何种材料进行填塞、填塞应留置多长时间或鼻腔填塞适应症的公认标准（埃格伦德和耶佩森，1992年；霍斯曼，1996年；韦伯等人，1996年b）。例如，许多作者在手术期间或手术后没有大量出血的情况下根本不使用填塞。在使用填塞的人中，一些人在手术当天取出，另一些人在术后5天内取出（综述见韦伯等人，1996年b）。大多数出版物描述了作者开发或偏爱的填塞材料的使用经验。关于填塞性质和持续时间的比较研究结果列于表1。本文对目前可用的材料进行了综述，并概述了它们各自的特性、适应症和风险。
