鼻中隔鼻道成形手術術後鼻填充物的另一種選擇—快鼻(Rapid Rhino)—

目的：進行鼻中隔鼻道成形(septomeatal plasty)手術時，各家醫院所使用的鼻填充材料都不盡相同，但大多能達到術後止血的效果。而術後抽去鼻填充物的過程中時常會帶給病人疼痛、頭暈、噁心、冒冷汗甚至大量出血等症狀，這也是病人住院期間最難以忍受的階段。因此本研究提出以快鼻(Rapid - Rhino)為術後的鼻填充材料，加以探討快鼻的優缺點。材料與方法：收集40例慢性肥厚性鼻炎併鼻中隔彎曲的病人，隨機分成A、B兩組，每組20人，進行鼻中隔鼻道成形手術。A組術後以快鼻，B組術後以美樂紗配合凡士林紗條作為鼻填充物。記錄A組術後及術後24小時氣囊內的空氣量並測量壓力，於術後24小時抽掉空氣，術後48小時將快鼻抽掉。B組病人術後24小時抽掉美樂紗，術後48小時抽掉凡士林紗條。追蹤A、B兩組病人術後8小時、24小時及48小時的Mankoski疼痛指數(Mankoski pain scale)及生活品質指數。記錄抽去快鼻、美樂紗及凡士林紗條時的不舒服症狀及視覺類比疼痛指數(visual analog scale , VAS)。比較鎮痛消炎藥及覆蓋鼻孔外側紗布的使用量。結果：使用快鼻的病人，可減少抽掉鼻填充物的不舒服感及疼痛指數，減少鎮痛消炎藥物的使用量，改善住院期間生活品質。但其缺點包括氣囊破裂和自行滑脫的危險性，且鼻中隔切口處(Killian's incision)較易流血，可於快鼻填塞後在其前方加上1塊至2塊凡士林紗條幫助止血。結論：快鼻在手術中填塞容易，抽去鼻填充物時不舒服感減少，疼痛感降低，抽掉快鼻不易大量出血，放氣後如果有流血情形可再度充氣止血。可當作術後鼻填充材料的另一種選擇。

關鍵字

慢性肥厚性鼻炎併鼻中隔彎曲；快鼻；美樂紗；凡士林紗條

並列摘要

Objective: Different hospitals use different nasal packing material for controlling postoperative bleeding after septomeatal plasty. Many patients suffer from pain, dizziness, headache, sweating, or severe bleeding when the nasal packing is removed. The purpose of this study was to depict and analyze the advantages and disadvantages of an alternative postoperative nasal packing material - Rapid Rhino. Materials and Methods: We conducted a trial of 40 patients who had chronic hypertrophic rhinitis with nasal septal deviation and who underwent septomeatal plasty. Patients were divided into either group A or B. Group A received Rapid Rhino, while group B received Merocels and vaseline gauze strips as nasal packing material. Air volume and air pressure with Rapid Rhino were recorded in group A patients immediately and 24 hours postoperatively. The packing material was deflated 24 hours after the operation and removed 48 hours postoperatively. Merocels were removed 24 hours and the vaseline gauze strips 48 hours after the operation in group B patients. The Mankoski pain scale and quality of life for group A and B patients were recorded at postoperative 8, 24, and 48 hours. Observations of any feelings of discomfort on a visual analog scale (VAS) were also recorded when removing the Rapid Rhino, Merocels, and vaseline gauze strips. Use of NSAID and gauze by these 2 groups was compared. Results: Patients who used the Rapid Rhino had decreased discomfort and pain when it was removed , as well as reduced consumption of NSAID and improved quality of life during hospitalization. However, its disadvantage included balloon rupture, danger of spontaneous dislocation, as well as easy bleeding at Killian's incision area, which could be controlled with 1 or 2 vaseline gauze strips over the anterior nostril. Conclusions: Rapid Rhino can be easily used postoperatively, and it is more comfortable and less painful and produces less active bleeding when it is removed. E

並列關鍵字

chronic hypertrophic rhinitis and nasal septum deviation ； Rapid Rhino ； Merocel ； vaseline gauze strip

國際替代計量

鼻中隔鼻道成形手術術後鼻填充物的另一種選擇—快鼻(Rapid Rhino)—

全文下載

主題瀏覽