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鼻中隔成形术后鼻中隔缝合术,它是鼻腔填塞的有效替代方法吗?

Suturing of the nasal septum after septoplasty, is it an effective alternative to nasal packing?

作者信息

Al-Raggad Daifallah K, El-Jundi Ali M, Al-Momani Osama S, Al-Serhan Mefleh M, Nawasrah Omar O, Qhawi Muafaq A, Husban Adnan M

机构信息

Department of Otolaryngology, Head and Neck Surgery Prince Hashem Ibn Al Hussein Hospital, Amman, Jordan.

出版信息

Saudi Med J. 2007 Oct;28(10):1534-6.

Abstract

OBJECTIVE

To discuss and compare the results of suturing the nasal septum after septoplasty with the results of nasal packing.

METHODS

A prospective study, which was performed at Prince Hashem Military Hospital in Zarqa, Jordan and Prince Rashed Military Hospital in Irbid, Jordan between September 2005 and August 2006 included 169 consecutive patients that underwent septoplasty. The patients were randomly divided into 2 groups. After completion of surgery, the nasal septum was sutured in the first group while nasal packing was performed in the second group.

RESULTS

Thirteen patients (15.3%) in the first group and 11 patients (13%) in the second group had minor oozing in the first 24 hours, 4 patients (4.8%) had bleeding after removal of the pack in the second group. Four patients (4.8%) developed septal hematoma in the second group. Two patients (2.4%) had septal perforation in the second group. One patient (1.1%) in the first group, and 5 patients (5.9%) in the second group had postoperative adhesions. Five patients (5.9%) were found to have remnant deviated nasal septum in each group. The operating time was 4 minutes longer in the first group.

CONCLUSION

Septal suturing after septoplasty offers the following advantages: elimination of discomfort for the patients, minimal complications, the outcome is almost the same as with nasal packing, and finally the hospital stay is less than with nasal packing. Therefore, suturing of the nasal septum after septoplasty should be a preferred alternative to nasal packing.

摘要

目的

探讨并比较鼻中隔成形术后缝合鼻中隔与鼻腔填塞的效果。

方法

一项前瞻性研究于2005年9月至2006年8月在约旦扎尔卡的哈希姆王子军事医院和伊尔比德的拉希德王子军事医院进行,纳入了169例连续接受鼻中隔成形术的患者。患者被随机分为两组。手术完成后,第一组对鼻中隔进行缝合,第二组进行鼻腔填塞。

结果

第一组有13例患者(15.3%)在术后24小时内有少量渗血,第二组有11例患者(13%);第二组有4例患者(4.8%)在取出填塞物后出血。第二组有4例患者(4.8%)发生鼻中隔血肿。第二组有2例患者(2.4%)出现鼻中隔穿孔。第一组有1例患者(1.1%),第二组有5例患者(5.9%)出现术后粘连。每组均有5例患者(5.9%)存在残余鼻中隔偏曲。第一组手术时间长4分钟。

结论

鼻中隔成形术后缝合鼻中隔具有以下优点:消除患者不适、并发症极少、效果与鼻腔填塞基本相同,且住院时间比鼻腔填塞短。因此,鼻中隔成形术后缝合鼻中隔应是鼻腔填塞的首选替代方法。

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