鼻内镜联合吸引剥离子在鼻中隔偏曲矫正手术中的应用体会

摘要

目的 总结鼻内镜联合吸引剥离子在鼻中隔偏曲矫正手术中的应用体会.方法 60例鼻中隔偏曲患者随机分为两组,每组各30例.观察组患者以鼻内镜联合吸引剥离子实施鼻中隔黏膜下矫正术,对照组行常规鼻内镜下鼻中隔矫正术.比较分析两组患者手术过程、术后疼痛、手术效果和鼻腔通气功能恢复程度及术后并发症发生情况.结果 观察组手术时间和术中出血量显著低于对照组(P<0.05);两组患者术后鼻塞、流涕、鼻出血、鼻痒及嗅觉减退评分均较术前显著降低(P<0.05),两组间比较差异无统计学意义(P>0.05).观察组术后12h、24h及3d时疼痛评分显著低于对照组(P<0.05);术后鼻中隔血肿、鼻中隔穿孔、结痂及复发率等的组间差异无统计学意义(P>0.05).结论 鼻内镜联合吸引剥离子用于鼻中隔偏曲矫正手术,能显著缩短手术时间,减少出血量,改善术后疼痛,有助于促进术后康复.%Objective To sum up the clinical experience with the application of a combined surgical procedure with nasal endoscope and suction detacher in the operation of nasal septum deviation based on a clinical trial. Methods Included in this trial were 60 patients with nasal septum deviation treated surgically in our Hospital, randomly divided into two groups, i.e. observation group (OG) and control group (CG), with 30 cases in each. Cases in OG were treated by submucous correction under nasal endoscope combined with suction detacher, while those in CG were treated by classic submucous correction, but under nasal endoscope as well. Then, observed and analyzed in a comparative way were the performing process of the operation, postoperative pain, operation effect, and the recovery level of nasal ventilation function as well as the incidence of postoperative complications. Results The operation time and total blood loss in OG were significantly lower than those in CG(P<0.05), while the scores of postoperative nasal congestion, runny nose, nasal bleeding, nasal itching and olfactory dysfunction were all decreased among the cases in these two groups (P<0.05) with no obviously statistical significance between them (P>0.05). However, the scores for postoperative pain evaluated at the time points of 12th and 24th hrs as well as the 3rd day were significantly lower in OG than those in CG (P<0.05). There were no significantly statistical significance (P>0.05) in the incidence of postoperative complications such as hematoma of nasal septum, nasal septum perforation, scar formation and lesion recurrence between these two groups also. Conclusion The surgical procedure under nasal endoscope combined with suction detacher can significantly shorten the operation time, reduce the total blood loss during the operating period, alleviating pain, and improve postoperative recovery.