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鼻中隔矫正术后无鼻腔填塞与单纯鼻腔填塞的鼻中隔缝合比较研究

A Comparative Study Between Septal Quilting Sutures Without Nasal Packing and Only Nasal Packing Post-septal Correction.

作者信息

Ramalingam Vijay, Venkatesan Rajarajan, Somasundaram Subramaniam, Kandasamy Kamindan, Rajeswari Murugesan

机构信息

KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu India.

TN MGR University, Chennai, Tamil Nadu India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2020 Jun;72(2):169-174. doi: 10.1007/s12070-019-01730-x. Epub 2019 Aug 16.

Abstract

Septal correction is the commonest surgery by rhinologists worldwide. We aimed at studying the comfort level of the patient with standard postoperative nasal packing with Merocel and placing quilting sutures in septum leaving the nose unpacked in the postoperative period. We conducted the study in the tertiary care centre enrolling 82 patients in a quasi-randomised method of odd and even numbers placing them in the nasal packing group and the quilting group respectively. We used analogue scoring method for subjective assessment of comfort level in the postoperative period and the surgeon objectively assessed the patient on follow up. The results were tabulated and analysed. Postoperative pain, headache and sleep disturbance was significantly more in the nasal packing group. We found that the crusting is commonly seen in patients in the nasal packing group. Quilting the nasal septum and leaving the nasal cavity unpacked increases the comfort level of the patient in the postoperative period. The resultant pain, headache and sleep disturbance caused by nasal packing can be significantly avoided by using quilting the septum without nasal packing. We also observed that by avoiding nasal packing postoperatively, the patients were more comfortable and compliant with the treatment regimen and follow-up.

摘要

鼻中隔矫正术是全球鼻科医生最常进行的手术。我们旨在研究使用美罗赛(Merocel)进行标准术后鼻腔填塞以及在鼻中隔放置褥式缝线并在术后不进行鼻腔填塞的情况下患者的舒适度。我们在一家三级医疗中心进行了这项研究,采用奇偶数准随机方法招募了82名患者,分别将他们置于鼻腔填塞组和褥式缝合组。我们使用视觉模拟评分法对术后舒适度进行主观评估,并且外科医生在随访时对患者进行客观评估。结果被制成表格并进行分析。鼻腔填塞组术后疼痛、头痛和睡眠障碍明显更多。我们发现鼻腔填塞组患者中结痂情况常见。对鼻中隔进行褥式缝合并使鼻腔不填塞可提高患者术后的舒适度。通过使用鼻中隔褥式缝合而不进行鼻腔填塞,可显著避免鼻腔填塞所导致的疼痛、头痛和睡眠障碍。我们还观察到,通过术后避免鼻腔填塞,患者感觉更舒适,并且更能遵守治疗方案和随访安排。

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本文引用的文献

1
Nasal septal clips: an alternative to nasal packing after septal surgery?鼻中隔夹:鼻中隔手术后鼻腔填塞的替代方法?
Indian J Otolaryngol Head Neck Surg. 2012 Dec;64(4):346-50. doi: 10.1007/s12070-011-0388-2. Epub 2011 Nov 30.
5
A comparative study of septoplasty with or without nasal packing.鼻中隔成形术有无鼻腔填塞的对比研究。
Indian J Otolaryngol Head Neck Surg. 2011 Jul;63(3):247-8. doi: 10.1007/s12070-011-0141-x. Epub 2011 Feb 23.
6
Rapid Rhino versus Merocel nasal packs in septal surgery.鼻中隔手术中快速犀牛牌与美罗赛尔鼻腔填塞物的比较
J Laryngol Otol. 2011 Dec;125(12):1244-6. doi: 10.1017/S0022215111002179. Epub 2011 Aug 19.

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