膨胀海绵鼻腔填塞在局部麻醉鼻内镜手术中的应用效果

目的探讨膨胀海绵鼻腔填塞在局部麻醉鼻内镜手术中的应用效果。方法随机选取2017—2018年行局部麻醉鼻内镜手术的慢性鼻窦炎患者40例,其中术中鼻腔后端填塞高膨胀海绵20例,填塞纱条20例。记录并比较两种填塞物患者的术中吐血量、吐血次数、手术时间、患者不适度的视觉模拟评分(VAS)。结果 20例膨胀海绵填塞患者术中经口吐血总次数(0.75±0.79)次,术中吐血总量(1.90±2.22)ml,手术时间(84.50±14.68)min,患者不适度VAS评分(3.05±1.14)分。术中吐血总次数、吐血总量、手术时间以及患者不适度评分中位值海绵填塞者少于纱条填塞者(P<0.05)。结论局部麻醉鼻内镜手术时,术中填塞膨胀海绵可有效减少术中创面出血的下流,减轻患者不适,缩短手术时间,值得临床推广。

Application of merocel during nasal endoscopic surgery under local anesthesia

Objective To investigate the effect of merocel in nasal endoscopic surgery under local anesthesia.Methods A total of forty patients with chronic rhinosinusitis who underwent endoscopic surgery under local anesthesia from 2017 to 2018 were randomly divided into two groups.Among them,20 cases of high expansion sponge were filled with merocel during operation,and 20 cases of yarn were stuffed with gauze strips during operation.The intraoperative bleeding volume,times of bleeding,time of operation and VAS(visual analog symptom scale)score of patients'discomfort during operation were recorded and compared.Results The total number of blood vomiting in 20 patients with expansive sponge stuffing was(0.75±0.79)time,the total amount of blood vomiting during operation was(1.90±2.22)ml,the operation time was(84.50±14.68)min,the patient uncomfort VAS score was(3.05±1.14)score.The total number of blood vomiting,the total amount of blood vomiting,the operation time and the moderate score of the patients were less than those of the yarn stuffing(P<0.05).Conclusion During endoscopic surgery under local anesthesia,filling Merocel can effectively reduce the flow of intraoperative wound bleeding,reduce the patients'discomfort,and shorten the operation time,which is worthy of clinical promotion.