Bista Meera
Department of ENT-HN Surgery, Kathmandu Medical College, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2017 Oct-Dec;56(208):442-6.
Nasal packing is one of the most common rhinological procedures in ENT practice exerting local in nose and systemic effects. Systemic effects may be due to poor sleep quality, respiratory difficulty, decreased oxygen saturation, circulatory problems and toxic shock syndrome which can threaten the life of a person.The study was done to investigate the effect on bilateral nasal packing on blood oxygen saturation and blood pressure changes.
A cross-sectional prospective study was undertaken in Kathmandu Medical College from January 2017 to June 2017. The ethical approval was taken from institutional review committee of KMC and verbal consent was taken from each patient. Thirty patients were included in the study by simple randomized sampling. The association between nasal packing and oxygen saturation and blood pressure was done using ANNOVA and Fisher Exact test. P value of <0.005 was considered statistically significant. SPSS version 20 for windows OS was used for analysis.
Blood oxygen saturation on four different days was compared using ANNOVA and paired sample tests. It showed a significant dip on the day of bilateral nasal packing compared to other readings (P value <0.001). Likewise, systolic and diastolic blood pressures showed a significant rise on the day of bilateral nasal packing compared to readings on other days (P value <0.001).
Bilateral nasal packing can lead to significant rise in systolic and diastolic blood pressure and a dip in blood oxygen saturation. Thus care has to be taken while performing bilateral nasal packing in normal patients but much more in high risk patients.
鼻腔填塞是耳鼻喉科最常见的鼻科手术之一，会对鼻腔产生局部影响并引发全身效应。全身效应可能是由于睡眠质量差、呼吸困难、血氧饱和度降低、循环问题以及可能危及生命的中毒性休克综合征所致。本研究旨在调查双侧鼻腔填塞对血氧饱和度和血压变化的影响。
2017年1月至2017年6月在加德满都医学院进行了一项横断面前瞻性研究。获得了加德满都医学院机构审查委员会的伦理批准，并征得每位患者的口头同意。通过简单随机抽样纳入30名患者进行研究。使用方差分析和Fisher精确检验来分析鼻腔填塞与血氧饱和度及血压之间的关联。P值<0.005被认为具有统计学意义。使用适用于Windows操作系统的SPSS 20版本进行分析。
使用方差分析和配对样本检验比较了四个不同日期的血氧饱和度。结果显示，与其他读数相比，双侧鼻腔填塞当天血氧饱和度显著下降（P值<0.001）。同样，与其他日期的读数相比，双侧鼻腔填塞当天收缩压和舒张压显著升高（P值<0.001）。
双侧鼻腔填塞可导致收缩压和舒张压显著升高以及血氧饱和度下降。因此，在对正常患者进行双侧鼻腔填塞时必须谨慎，而对高危患者则更应如此。
