自制鼻咽通气管在鼻中隔穿孔修复术鼻腔填塞中的应用

摘要

Objective To explore the application methods of homemade nasopharyngeal airway in the nasal septum perforation repair of nasal packing and the influence of postoperative reaction. Methods 155 patients were randomly divided into the nasopharyngeal airway group(n = 77) and the control group (n =78). After the nasal septum perforation repair, bilat eral inferior meatus were filled with the expansion of the sponge which were amended to adapt to nasal width, length in the na sopharyngeal airway group, and the T-tube with a diameter of 0.6 cm was put into the end of nose, whereafter bilateral medial wall of the front of T-tube were sutured and fixed in the front of nasal columella, the other regions within the nasal cavity were filled with the expansion of the sponge. The nasopharyngeal airway was removed after perforation healed completely. The con trol group was only filled with the expansion of sponge for nasal packing. The headache, nasal pain level, postoperative com plications and sleep at night of two groups were recorded 24 h after operation and for statistical analysis. Results The headache , nasal pain level and sleep at night in the nasopharyngeal airway group showed statistical significance when compared with that of the control group (P 0.05). 3 patients with nasopharyngeal bleeding in the nasopharyngeal airway group, among them 2 patients had self-stop bleeding, 1 patient took hemostasis by finger pressing; 6 patients with airway detachment; 4 patients with airway obstruction. Conclusion The application of homemade nasopharyngeal airway in the nasal septum perforation repair of nasal packing, can improve the long-term postoperative nasal dressings change and nasal ventilation. The method is simple and less irritating to the nasal cavity and is of good tolerance.%目的 探讨鼻咽通气管在鼻中隔穿孔修补术鼻腔填塞中的应用方法及对术后反应的影响.方法 随机将155例分为鼻咽通气管组(n=77)和对照组(n=78),鼻咽通气管组在鼻中隔穿孔修补结束后,将修整为与下鼻道宽窄、长短相适应的膨胀海绵填入双侧下鼻道,鼻底置入内径0.6cm的T型管,双侧T型管前端内侧壁缝扎固定在鼻小柱前方,鼻腔内其他区域予膨胀海绵填塞,通气管放置至穿孔完全愈合后取出.对照组仅予膨胀海绵填塞鼻腔.术后24h记录两组头痛、鼻腔胀痛程度、夜间睡眠情况及术后并发症并进行统计学处理.结果 术后鼻腔通气管组头痛和鼻腔胀痛程度及夜间睡眠情况与对照组比较差异有统计学意义(P＜0.01)；两组口咽干燥感比较差异无统计学意义(P＞0.05).术后鼻咽通气管组出血3例,2例自行止血,1例重新压迫后止血；术后脱管6例,堵管4例.结论 鼻中隔穿孔修补术后放置鼻咽通气管解决了术后鼻腔长期换药、填塞中鼻腔通气问题,该方法操作简单,对鼻腔刺激性较小,患者耐受性好.