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一种用于鼻中隔成形术的无鼻腔填塞经鼻中隔夹板缝合新方法。

A novel way of trans-septal splint suturing without nasal packing for septoplasty.

作者信息

Naik Kiran

机构信息

Adichunchanagiri Institute of Medical Sciences & Research Institute, B.G. Nagar, Nagamangala, Mandya, Karnataka India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(1):48-50. doi: 10.1007/s12070-014-0763-x. Epub 2014 Aug 10.

Abstract

Nasal packing has evolved over the years. Though effective in preventing postoperative bleeding complications, they are associated with significant morbidity and pain. In recent years nasal splints have been used to reduce the duration of nasal packs. The aim of this study is to compare the postoperative results in 200 nasal surgeries where in nasal packing was replaced by trans-septal splint suturing. Two hundred cases of septoplasties were prospectively studied over a period of 5 years at Adichunchanagiri Institute of Medical Sciences. In 100 cases (group A) nasal packing was done postoperatively whereas in other 100 (group B) trans-septal splint suturing was done. Post operatively patients were followed up in both groups regarding the presence of pain, bleeding, crusting and synechiae for a period of 6 months. Two hundred patients were prospectively studied over a period of 5 years with a male-female ratio of 1.35:1 and the mean age was 31. In group A out of 100 patients followed postoperatively, ten had mild bleeding on second day after pack removal none of which required repacking, 22 patients had mild pain on second and third day, 18 had moderate crusting on day 4, 12 had synechiae after 2 weeks. In group B, out of 100 patients, minimal bleeding was noted in 13 patients on day 1 and 2, mild discomfort was noted in the nose in 34 patients till day 7 (day of splint removal), crusting was noted in six patients, synechiae was noted in one patient. Elimination of pain and discomfort for the patients and absence of complications like synechiae. Also the hospital stay is less than with nasal packing. Therefore, suturing of the nasal septum with a splint after septoplasty should be a preferred alternative to nasal packing.

摘要

多年来,鼻腔填塞技术不断发展。尽管它在预防术后出血并发症方面很有效,但却伴随着较高的发病率和疼痛。近年来,鼻夹板已被用于缩短鼻腔填塞的时间。本研究的目的是比较200例鼻腔手术的术后结果,这些手术中鼻腔填塞被鼻中隔夹板缝合所取代。在阿迪昌查纳吉里医学科学研究所,对200例鼻中隔成形术病例进行了为期5年的前瞻性研究。其中100例(A组)术后进行鼻腔填塞,另外100例(B组)进行鼻中隔夹板缝合。术后对两组患者进行了为期6个月的随访,观察疼痛、出血、结痂和粘连情况。对200例患者进行了为期5年的前瞻性研究,男女比例为1.35:1,平均年龄为31岁。在A组的100例术后随访患者中,10例在取出填塞物后的第二天有轻微出血,均无需再次填塞;22例在第二天和第三天有轻微疼痛;18例在第4天有中度结痂;12例在2周后出现粘连。在B组的100例患者中,13例在第1天和第2天有少量出血;34例患者在第7天(取出夹板的日子)前鼻子有轻微不适;6例有结痂;1例有粘连。消除了患者的疼痛和不适,且没有出现粘连等并发症。此外,住院时间也比鼻腔填塞时短。因此,鼻中隔成形术后用夹板缝合鼻中隔应是鼻腔填塞的首选替代方法。

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