Melis Andrea, Karligkiotis Apostolos, Bozzo Corrado, Machouchas Nikolaos, Volpi Luca, Castiglia Paolo, Castelnuovo Paolo, Meloni Francesco
Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.
Laryngoscope. 2015 May;125(5):1067-71. doi: 10.1002/lary.25105. Epub 2014 Dec 29.
OBJECTIVES/HYPOTHESIS: To compare the extent of bleeding and patient discomfort during packing removal of three different polyvinyl alcohol (PVA) packs: 1) a standard PVA sponge (s-PVA) (Mondocel Standard 10 cm; Mondomed NV, Hamont-Achel, Belgium); 2) a PVA sponge with oxidized cellulose (oc-PVA) (Merocel Hemox 10 cm; Medtronic Xomed Surgical Products, Jacksonville, FL); and 3) a PVA sponge with polyethylene film (pf-PVA) (Merocel 2000 8 cm; Medtronic Xomed Surgical Products, Jacksonville, FL), after functional endoscopic sinus surgery and inferior turbinoplasty.
A prospective, randomized, blinded, controlled trial.
Ninety consecutive patients were enrolled and randomized to receive in each side one pack in the middle meatus and another pack of the same material in the nasal fossa. The patients were equally divided in three groups of 30 patients each. Group A received the pf-PVA; group B received oc-PVA; and group C received s-PVA. Postoperatively, bleeding after removal of the entire nasal packing was evaluated by an observer, whereas the severity of pain was rated by patients with visual analog scales.
Our study evaluated three nasal packing materials, demonstrating that the pf-PVA is less painful than the others but with intermediate bleeding ratio. However, the oc-PVA has an intermediate pain score but minimum bleeding. The s-PVA showed the worst pain and bleeding results.
Considering that removal of the second pack (middle meatus) is more painful than the first (nasal fossa), our results suggest that a pf-PVA can be placed in the middle meatus and a oc-PVA in the nasal fossa in order to reduce patient's discomfort in terms of pain and bleeding.
1b.
目的/假设：比较三种不同聚乙烯醇（PVA）填塞物在取出时的出血程度和患者不适情况，这三种填塞物分别为：1）标准PVA海绵（s-PVA）（Mondocel标准型10厘米；Mondomed NV公司，比利时哈蒙特-阿赫尔）；2）含氧化纤维素的PVA海绵（oc-PVA）（Merocel Hemox 10厘米；美敦力Xomed外科产品公司，佛罗里达州杰克逊维尔）；3）含聚乙烯薄膜的PVA海绵（pf-PVA）（Merocel 2000 8厘米；美敦力Xomed外科产品公司，佛罗里达州杰克逊维尔），用于功能性鼻内镜鼻窦手术和下鼻甲成形术后。
一项前瞻性、随机、双盲、对照试验。
连续纳入90例患者，随机分为三组，每组30例。每组患者双侧分别在中鼻道放置一种填塞物，在鼻腔底部放置相同材料的另一种填塞物。A组接受pf-PVA；B组接受oc-PVA；C组接受s-PVA。术后，由一名观察者评估取出整个鼻腔填塞物后的出血情况，而疼痛程度由患者通过视觉模拟评分法进行评分。
我们的研究评估了三种鼻腔填塞材料，结果表明pf-PVA引起的疼痛比其他两种轻，但出血率中等。然而，oc-PVA的疼痛评分中等，但出血最少。s-PVA的疼痛和出血情况最差。
考虑到取出第二块填塞物（中鼻道）比第一块（鼻腔底部）更疼，我们的结果表明，可在中鼻道放置pf-PVA，在鼻腔底部放置oc-PVA，以减轻患者在疼痛和出血方面的不适。
1b。
