Orlandi Richard R, Lanza Donald C
Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.
Laryngoscope. 2004 Sep;114(9):1541-4. doi: 10.1097/00005537-200409000-00007.
OBJECTIVES/HYPOTHESIS: To determine the necessity of nasal packing or hemostatic agents or both following endoscopic sinus surgery.
Retrospective review of cases in a tertiary care sinus practice at an academic medical center.
Records of 165 patients undergoing 169 endoscopic sinus surgeries were reviewed to determine the presence of adjunctive nasal procedures, the use of nasal packing or hemostatic agents or both, blood loss during surgery, and the incidence of bleeding complications following surgery.
The median estimated blood loss during surgery was 50.0 mL (range, 5-1000 mL). In four surgeries (2.4%) hemostatic agents were placed in the nose at the conclusion of surgery, 19 (11.2%) had packing, and 147 (87.0%) had no material left in the nose. No patients had bleeding complications postoperatively. There was a significant decrease in the use of packing or hemostatic agents or both over time.
Placement of nasal packing or other hemostatic agents or both within the nasal cavity is not necessary in the majority of endoscopic sinus surgeries. The risks, costs, and discomforts associated with these interventions can often be avoided.
目的/假设：确定鼻内镜鼻窦手术后使用鼻腔填塞、止血剂或两者的必要性。
对一所学术医疗中心三级鼻窦治疗实践中的病例进行回顾性研究。
回顾165例患者接受169次鼻内镜鼻窦手术的记录，以确定辅助鼻腔手术的情况、鼻腔填塞或止血剂或两者的使用情况、手术中的失血量以及术后出血并发症的发生率。
手术中估计失血量的中位数为50.0毫升（范围为5 - 1000毫升）。4例手术（2.4%）在手术结束时在鼻腔内放置了止血剂，19例（11.2%）进行了填塞，147例（87.0%）鼻腔内未留置任何材料。没有患者术后出现出血并发症。随着时间的推移，填塞或止血剂或两者的使用显著减少。
在大多数鼻内镜鼻窦手术中，无需在鼻腔内放置鼻腔填塞物或其他止血剂或两者。这些干预措施相关的风险、成本和不适通常可以避免。
