鼻内镜辅助下连续贯穿缝合和鼻腔填塞在鼻中隔偏曲矫正术中的应用

Application of nasal endoscopic continuous penetrating suture and nasal packing in deflection of nasal septum plasty

摘要:

目的 分析连续贯穿缝合和鼻腔填塞分别用于鼻中隔偏曲（DNS）矫正术后对患者舒适度和并发症发生情况的影响。方法 回顾性分析2018年3月－2023年3月该院116例行DNS矫正术治疗的患者的临床资料，术后采用鼻腔填塞的患者为填塞组（69例），术后采用连续贯穿缝合的患者为缝合组（47例）。比较两组患者术后第3和7天因鼻腔换药引起的疼痛评分［采用视觉模拟评分法（VAS）评估］和鼻出血评分，术后第3天主观不适感（头痛、口干，溢泪、睡眠困难、鼻塞和鼻部疼痛）评分，术前和术后第14天鼻腔吸气和呼气总阻力，术后1个月并发症发生情况。结果 缝合组术后第3天行鼻腔换药引起的疼痛VAS和鼻出血评分低于填塞组，差异均有统计学意义（P < 0.05）。缝合组术后第3天主观不适感评分低于填塞组，差异有统计学意义（P < 0.05）。缝合组术后第14天鼻腔吸气总阻力和呼气总阻力低于填塞组，差异均有统计学意义（P < 0.05）。缝合组术后并发症总发生率低于填塞组，差异有统计学意义（P < 0.05）。结论 与鼻腔填塞相比，鼻内镜辅助下连续贯穿缝合用于DNS矫正术，能够减轻患者疼痛，减少出血，缓解患者术后主观不适感，改善鼻腔通气功能，并减少术后并发症的发生。

Abstract:

Objective To analyze the effects of nasal endoscopic continuous penetrating suture and nasal packing on discomfort and complications in patients undergoing deflection of nasal septum (DNS) plasty.Methods 116 patients undergoing DNS plasty were enrolled between March 2018 and March 2023, including 69 cases in packing group score (nasal packing) and 47 cases in suture group (continuous penetrating suture). The scores of pain[evaluated by visual analogue scale (VAS)] and epistaxis caused by nasal dressing changes at 3 and 7 d after surgery, subjective discomfort score (headache, dry mouth, epiphora, sleep difficulties, nasal obstruction and nasal pain) at 3 d after surgery, total inspiratory and expiratory resistance before and at 14 d after surgery, and the occurrence of complications at 1 month after surgery were compared between the two groups.Results At 3 d after surgery, VAS of pain and epistaxis score caused by nasal dressing changes were lower in suture group than packing group (P < 0.05), and score of subjective discomfort was lower in suture group (P < 0.05). At 14 d after surgery, total inspiratory and expiratory resistance were lower in suture group than packing group (P < 0.05). The total incidence of postoperative complications was lower in suture group than packing group (P < 0.05).Conclusion Compared with nasal packing, nasal endoscopic continuous penetrating suture can reduce pain and bleeding, improve postoperative subjective discomfort and nasal ventilation function, and reduce complications after DNS plasty.