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目的为选择更适合鼻内镜术临床应用的填塞材料,总结归纳塞纳斯凝胶在慢性鼻-鼻窦炎伴鼻息肉(CRSw NP)引起的睡眠呼吸障碍(SDB)患者行鼻内镜术中的应用情况,探讨SDB患者与非SDB患者应用塞纳斯凝胶后其舒适度的差异。方法双侧CRSw NP成人患者216例施行鼻内镜手术,其中伴SDB 156例,不伴SDB60例。分为4个组,其中A组为不伴SDB患者术中填塞塞纳斯凝胶60例、B组为伴SDB患者术中填塞塞纳斯凝胶组56例,C组为伴SDB患者术中填塞纳吸棉组47例,D组为伴SDB患者术中填塞医用膨胀海绵组53例。采用视觉模拟评分法(VAS)对其鼻腔反应进行比较。结果 A组和B组比较,塞纳斯凝胶在头痛、鼻痛及术后出血三方面差异有统计学意义(P<0.05),SDB患者在这三方面更不耐受。B组与C组比较,在头痛、鼻痛、鼻塞感、流泪四方面差异有统计学意义(P<0.05),塞纳斯凝胶优于纳吸棉。B组与D组比较,在头痛、鼻痛、鼻塞感、流泪、吞咽障碍、术后出血6个方面差异均有统计学意义(P<0.05),但临床意义不同,在术后出血方面塞纳斯凝胶组的效果虽差于医用膨胀海绵组,但仍可接受,其余方面塞纳斯凝胶明显优于膨胀海绵。结论塞纳斯凝胶是更适合于临床应用的填塞材料,能为患者带来更高的术后舒适度。另外SDB能加重患者头痛、鼻痛和术后出血症状,可能与长期缺氧致炎症反应较重有关。
Objective To select the more suitable stuffing material for clinical application of endoscopic sinus surgery and summarize the effect of Senegal gel on endoscopic sinus surgery in patients with sleep disordered breathing (SDB) caused by chronic rhinosinusitis and nasal polyps (CRSw NP) Application, to explore the SDB patients and non-SDB patients after the application of Senegal gel its comfort differences. Methods Two hundred and sixty-two adult CRSw NP patients underwent endoscopic sinus surgery, including 156 cases of SDB and 60 cases of SDB without SDB. Divided into four groups, including A group of non-SDB patients filled with Senegal gel surgery in 60 cases, B group with SDB patients intraoperative sealing Senes gel group 56 cases, C group with SDB patients with intraoperative filling Seine aspirates in 47 cases, D group with SDB in patients with surgical stuffing 53 cases of medical sponge. Visual analogue scale (VAS) was used to compare nasal responses. Results There was significant difference in the headache, nasal pain and postoperative bleeding between the A group and the B group (P <0.05). SDB patients were more intolerant in these three aspects. Compared with group C, group B had statistically significant differences in headache, nasal pain, nasal congestion, and tearing (P <0.05), and Senegal gel was superior to nanospun cotton. The differences of group B and group D were statistically significant (P <0.05) in six aspects of headache, nasal pain, nasal congestion, lacrimation, swallowing, and postoperative bleeding, but the clinical significance was different. Although the effect of the gel group was worse than that of the medical expanded sponge group, it was still acceptable. The rest of the gel was better than the expanded sponge. Conclusion Senegal gel is more suitable for clinical application of packing material, can bring patients with higher postoperative comfort. In addition SDB can aggravate headache, nasal pain and postoperative bleeding symptoms, may be associated with long-term hypoxia-induced inflammatory response heavier.