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目的:探讨功能性内镜鼻窦手术(FESS)后不做填塞的安全性和可行性,并对适应证进行研究。方法:对74例慢性鼻窦炎患者(不填塞组)在FESS术后不进行填塞(保障措施包括:适当的病例选择,术前和术后抗炎,止血药物治疗,术中减少损伤,术后细致的防粘连处理),并与填塞组(20例)进行对比分析。结果:不填塞组在FESS术后均无严重出血发生,术后渗血在2~6h内基本停止;在3个月的随访期内无术腔严重粘连发生。结论:采取适当的处理和预防措施,大多数FESS术后患者可不进行填塞,这可明显减轻患者的术后痛苦,降低治疗成本,也使患者对FESS治疗的依从性增加。
Objective: To investigate the safety and feasibility of not filling after functional endoscopic sinus surgery (FESS), and to study the indications. Methods: Totally 74 patients with chronic sinusitis (non-stuffed group) were not stuffed after FESS (safeguards included: appropriate case selection, preoperative and postoperative anti-inflammatory and hemostatic drug treatment, intraoperative reduction of injury, postoperative Meticulous anti-adhesion treatment), and compared with the stuffing group (20 cases). Results: There was no severe hemorrhage in FESS postoperatively in non-stuffed group. The postoperative bleeding basically stopped within 2 ~ 6 hours. No severe intraoperative adhesions occurred within 3 months of follow-up. Conclusion: With appropriate treatment and preventive measures, most patients with postoperative FESS can not be stuffed. This can significantly reduce the postoperative pain, reduce the cost of treatment, and increase the compliance of patients with FESS.