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目的回顾性分析比较2种鼻腔填塞材料的疗效,寻找术中中鼻道填塞材料,指导临床鼻腔手术中填塞材料的选择。方法选择我科2008年--2010年鼻窦手术中应用凡士林纱条、生物止血棉填塞材料的病例120例,所以病例来自同一手术治疗组,采用相同的手术设备及相同的术后随访方式,手术器械,鼻内镜监视系统,所有手术均在鼻内镜监视系统下实施。选取同型病例比较术后中鼻道填塞材料,在达到术后止血的前提下,比较术后三天、一周、一月的术腔情况。结果三天:纱条组术腔血痂及分泌物填塞,生物止血棉组血性液体渗透;一周:纱条组:术腔纤维粘性渗出物,生物止血棉组:呈果胶状,暗红色,部分填充于术腔;一月:纱条组:术腔基本上皮化,中道粘连较高<10%,生物止血棉组:术腔基本上皮化,中道粘连率<2%。结论止血棉在应用于慢性鼻窦炎(Ⅰ、Ⅱ型患者)中道填塞中,术后一月中鼻甲与鼻腔外侧壁粘连发生率明显下降。
Objective To retrospectively analyze and compare the curative effect of two kinds of nasal packing materials, to find intraoperative nasal packing materials and to guide the choice of packing material in clinical nasal surgery. Methods Select our department from 2008 to 2010 sinus surgery with Vaseline gauze, biological material to stop bleeding stuffing 120 cases, so the cases from the same surgical treatment group, using the same surgical equipment and the same postoperative follow-up, surgery Instruments, endoscopic surveillance system, all operations under the endoscopic surveillance system. Select the same type of cases after surgery compared with the material of the nasal obstruction, to achieve the premise of postoperative hemostasis, the comparison of three days, one week, January surgery. The results of three days: sliver blood clots and secretions packing gauze, biological hemostatic cotton group bloody liquid penetration; one week: gauze group: intraoperative fibroids viscous exudate, biological hemostatic cotton group: pectin-like, dark red , Partially filled in the cavity; January: gauze group: the basic lumen of the cavity, middle high adhesion <10%, biological hemostatic cotton group: the basic lumen of the cavity, the middle wall adhesion rate <2%. Conclusion The application of hemostatic cotton in the middle-pathological filling of chronic sinusitis (type Ⅰ and type Ⅱ patients), the incidence of middle turbinate and lateral nasal wall adhesions was significantly decreased in January.