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内镜鼻窦手术后透明质酸/羧甲基纤维素敷料的随机对照试验

Randomized controlled trial of hyaluronic acid/carboxymethylcellulose dressing after endoscopic sinus surgery.

作者信息

Woodworth Bradford A, Chandra Rakesh K, Hoy Mark J, Lee Fu-Shing, Schlosser Rodney J, Gillespie M Boyd

机构信息

Department of Otolaryngology/Head and Neck Surgery, Medical University of South Carolina Hospital, Charleston, SC 29425, USA.

出版信息

ORL J Otorhinolaryngol Relat Spec. 2010;72(2):101-5. doi: 10.1159/000276877. Epub 2010 May 5.

Abstract

OBJECTIVE

To determine if a hyaluronic acid/carboxymethylcellulose (HA/CMC) sinus dressing reduces the rate of postoperative scarring.

METHODS

In a randomized, matched-controlled, single-blinded study, following the completion of surgery, an HA/CMC dressing was randomly assigned to one side with the opposite unpacked side serving as a control.

RESULTS

Fifty-three patients underwent surgery for chronic rhinosinusitis (CRS; 39 patients) or CRS with nasal polyposis (14 patients). At the 8-week follow-up, there was no difference in synechiae on the HA/CMC side compared to the control (p = 0.09). HA/CMC-treated sinuses, however, demonstrated fewer synechiae in the first 2 weeks postoperatively compared to the control (p = 0.01), and were associated with significantly less nasal congestion at the 4-week (p = 0.02) and 8-week follow-up visits (0.03).

CONCLUSION

There was no long-term difference in the rate of synechiae in the HA/CMC-treated sinus compared to the control. However, less severe nasal congestion and synechiae in the initial postoperative period may reduce the need for aggressive sinus debridement.

摘要

目的

确定透明质酸/羧甲基纤维素(HA/CMC)鼻窦敷料是否能降低术后瘢痕形成率。

方法

在一项随机、匹配对照、单盲研究中,手术完成后,将HA/CMC敷料随机分配至一侧,另一侧未包装作为对照。

结果

53例患者接受了慢性鼻窦炎(CRS;39例患者)或伴鼻息肉的CRS(14例患者)手术。在8周随访时,与对照相比,HA/CMC侧的粘连情况无差异(p = 0.09)。然而,与对照相比,HA/CMC处理的鼻窦在术后第1周粘连较少(p = 0.01),并且在4周(p = 0.02)和8周随访时鼻充血明显较少(p = 0.03)。

结论

与对照相比,HA/CMC处理的鼻窦粘连率无长期差异。然而,术后初期较轻的鼻充血和粘连可能减少积极鼻窦清创的必要性。

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