鼻腔填塞纳吸棉对慢性鼻窦炎患者鼻内镜术后舒适度的影响观察

Effect of nasal packing with merocel on postoperative comfort in patients undergoing endoscopic sinus surgery for chronic sinusitis

  • 摘要: 目的 观察鼻腔填塞纳吸棉对慢性鼻窦炎患者鼻内镜术后舒适度的影响。方法 选取慢性鼻窦炎并接受鼻内镜下手术患者,采用随机数字表法分为观察组(采用纳吸棉填塞止血)与对照组(采用明胶海绵填塞止血),每组71例。比较2组患者鼻部胀痛与头痛程度、鼻腔通气状况(鼻腔气道阻力、鼻腔阻塞程度)、鼻腔出血情况,依从性评分、不适感视觉模拟评分法(VAS)总评分、鼻内镜Lund-Kennedy评分及相关治疗指征(感染、鼻道粘连、窦口通畅、肉芽增生)评分。结果 观察组患者术后24 h鼻部胀痛及头痛程度均轻于对照组,术后24 h鼻腔阻塞程度轻于对照组,鼻腔气道阻力小于对照组,患者术后48 h鼻腔出血程度轻于对照组,差异均有统计学意义(P<0.05); 2组患者术后依从性评分差异无统计学意义(P>0.05), 观察组患者不适感VAS总评分及鼻内镜Lund-Kennedy评分均低于对照组,差异有统计学意义(P<0.05); 2组术后4周感染、窦口通畅、肉芽增生相关指征评分差异无统计学意义(P>0.05), 观察组患者鼻道粘连评分低于对照组,差异有统计学意义(P<0.05)。结论 纳吸棉作为鼻内镜术后鼻腔填塞物,能更有效减轻患者术后疼痛、鼻腔阻塞等不适,降低早期出血和远期鼻腔粘连的风险,提高术后舒适度。

     

    Abstract: Objective To observe the effect of nasal packing with merocel on postoperative comfort in patients undergoing endoscopic sinus surgery for chronic sinusitis. Methods Patients with chronic sinusitis who underwent endoscopic sinus surgery were selected and randomly divided into observation group (packed with merocel for hemostasis) and control group (packed with gelatin sponge for hemostasis) using a random number table method, with 71 cases in each group. The degrees of nasal swelling pain and headache, nasal ventilation status (nasal airway resistance, degree of nasal obstruction), nasal bleeding, compliance scores, total discomfort scoresVisual Analogue Scale (VAS), endoscopic Lund-Kennedy scores, and scores of related treatment indicators (infection, nasal meatal adhesion, patency of ostium, granulation hyperplasia) were compared between the two groups. Results The degrees of nasal swelling pain, headache and the degree of nasal obstruction at 24 h postoperatively in the observation group were milder than those in the control group, the nasal airway resistance was lower, and degree of nasal bleeding at 48 h postoperatively in the observation group was milder than that in the control group(P < 0.05). There was no statistically significant difference in postoperative compliance scores between the two groups (P>0.05). The total discomfort VAS score and endoscopic Lund-Kennedy score in the observation group were lower than those in the control group (P < 0.05). There were no statistically significant differences in the scores of indicators related to infection, patency of ostium, and granulation hyperplasia at 4 weeks postoperatively between the two groups (P>0.05). The score of nasal meatal adhesion in the observation group was lower than that in the control group (P < 0.05). Conclusion As a nasal packing material after endoscopic sinus surgery, merocel can more effectively alleviate postoperative discomfort such as pain and nasal obstruction, reduce the risk of early bleeding and long-term nasal meatal adhesion, and improve postoperative comfort.

     

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