Chevillard Christine, Rugina Michel, Bonfils Pierre, Bougara Ali, Castillo Laurent, Crampette Louis, Pandraud Luc, Samardzic Marina, Peynègre Roger
Laboratoires Brothier, Nanterre, France.
Rhinology. 2006 Mar;44(1):58-61.
Nasal packing is commonly used to control postoperative bleeding in patients undergoing endonasal surgical procedures. Bleeding and pain on packing removal are frequently reported. The principal objective of this study was to investigate the efficacy and safety of Algosteril to control post-operative nasal bleeding. The secondary objective was to assess nasal bleeding and pain on packing removal, and to evaluate the endoscopic appearance of nasal mucosa 9 days after the procedure. This open, multicenter, randomized, controlled study was conducted on 50 patients undergoing partial bilateral inferior turbinectomy, packed with Algosteril on one side versus Polyvinyl acetal tampon (Merocel) on the other side following a left/right randomization. Both nasal packs effectively prevented post-operative bleeding. However, bleeding on packing removal was statistically less frequent and less severe with Algosteril than with Polyvinyl acetal (p = 0.016). In addition, pain was statistically lower with Algosteril than with Polyvinyl acetal (p = 0.0001). A trend to a better healing of the wound on day 9 was observed with Algosteril, leading us to further investigations. Algosteril nasal packing is as effective as Polyvinyl acetal in preventing postoperative bleeding following partial inferior turbinate resection. Its removal, however, is less traumatic for the nasal mucosa and less painful for the patient, therefore improving patient's comfort.
鼻腔填塞常用于控制接受鼻内手术患者的术后出血。移除填塞物时的出血和疼痛屡有报道。本研究的主要目的是调查Algosteril控制术后鼻出血的有效性和安全性。次要目的是评估移除填塞物时的鼻出血和疼痛情况，并评估术后9天鼻黏膜的内镜表现。这项开放性、多中心、随机对照研究对50例行双侧部分下鼻甲切除术的患者进行，按照左右随机分组，一侧用Algosteril填塞，另一侧用聚乙烯醇缩醛棉塞（Merocel）填塞。两种鼻腔填塞物均有效预防了术后出血。然而，与聚乙烯醇缩醛相比，使用Algosteril移除填塞物时出血的发生率在统计学上更低且严重程度更轻（p = 0.016）。此外，使用Algosteril时的疼痛在统计学上低于使用聚乙烯醇缩醛时（p = 0.0001）。观察到使用Algosteril在第9天时伤口愈合有更好的趋势，促使我们进行进一步研究。Algosteril鼻腔填塞在预防部分下鼻甲切除术后的术后出血方面与聚乙烯醇缩醛同样有效。然而，其移除对鼻黏膜的创伤更小，对患者的疼痛也更小，因此提高了患者的舒适度。
