Celebi Saban, Caglar Erdem, Develioglu Omer N, Topak Murat, Yalcin Enis, Kulekci Mehmet
Department of Otolaryngology, Taksim Education and Research Hospital, Istanbul, Turkey.
J Craniofac Surg. 2013 Jul;24(4):1232-4. doi: 10.1097/SCS.0b013e31828a72a2.
We examined the effects of the duration of keeping a Merocel nasal packing in the nose and the application technique (packing applied either directly or inside a glove finger) on postoperative morbidity and complications. The study included 129 patients (67 males and 62 females; age range 18 to 56 years) undergoing nasal septoplasty without turbinate intervention. The patients were randomly assigned into 4 groups. In group 1 and group 2, Merocel was directly applied in the nasal cavity for 24 hours and 48 hours, respectively; in group 3 and group 4, Merocel was kept in the nasal cavity in a powder-free glove finger for 24 hours and for 48 hours, respectively. Pain and discomfort scores were evaluated by a visual analog scale. The time taken between removal of the tampon and when the patients began to breathe comfortably was called the nasal obstruction time. The differences in mean discomfort score between the groups were not statistically significant (P > 0.05), while the mean pain scores were statistically higher in groups 1 and 2 than in groups 3 and 4 (P < 0.05). The nasal obstruction time was statistically shorter in groups 2 and 4 than in groups 1 and 3 (P < 0.05). Therefore, keeping Merocel inside a glove finger in place for 48 hours notably reduces the pain occurring during the removal of the nasal tampon. It also reduces nasal obstruction time and prevents synechia, leakage, bleeding, and septal hematoma, without compromising patient comfort.
我们研究了美罗赛鼻腔填塞物在鼻腔内留置时间及应用技术（直接填塞或置于手套指套内填塞）对术后发病率和并发症的影响。该研究纳入了129例接受鼻中隔成形术且未干预鼻甲的患者（67例男性和62例女性；年龄范围18至56岁）。患者被随机分为4组。在第1组和第2组中，美罗赛分别直接应用于鼻腔24小时和48小时；在第3组和第4组中，美罗赛分别置于无粉手套指套内留置在鼻腔24小时和48小时。采用视觉模拟量表评估疼痛和不适评分。取出填塞物至患者开始舒适呼吸的时间称为鼻塞时间。各组间平均不适评分差异无统计学意义（P>0.05），而第1组和第2组的平均疼痛评分在统计学上高于第3组和第4组（P<0.05）。第2组和第4组的鼻塞时间在统计学上短于第1组和第3组（P<0.05）。因此，将美罗赛置于手套指套内留置48小时可显著减轻取出鼻腔填塞物时出现的疼痛。它还能缩短鼻塞时间并预防粘连、渗漏、出血和鼻中隔血肿，且不影响患者舒适度。
