指套填塞法使用於鼻竇內視鏡手術

背景：鼻填塞在鼻竇內視鏡手術後可止血及防止傷口沾粘，是常用的處置法。目前市面上有多種材質可供選擇使用。本文旨在探討本院所採用的凡紗指套填塞，與傳統使用的凡士林紗條及Merocel，3種材質在鼻竇炎病人接受鼻竇內視鏡手術後行鼻填塞的優缺點。方法：自1996年10月至1997年12月接受鼻竇內視鏡手術之鼻竇炎病人中，以Kennedy Staging System 依其在鼻竇電腦斷層攝影上的表現，選出30名雙側病灶同期的病人，以凡士林紗條、Merocel、及凡紗指套3種材質進行術後鼻填塞之比較，分別探討3種材質於鼻填塞移除時所引起的疼痛程度及所需要的花費。結果：傳統使用的凡士林紗條的優點為便宜，可塑性高，缺點為移除時病人不適度最高；Merocel所引起的不適度最低，但價格昂貴為其缺點。凡紗指套填塞法則兼具兩者的優點：病人的不適度低，價格便宜，而且製作方式容易。因此，對鼻竇內視鏡手術後的病人而言，凡綜套填塞法是理想的鼻填塞方式。

關鍵字

指套填塞法；鼻填塞；鼻竇內視鏡手術

並列摘要

Background: Postoperative nasal packing is universally used following routine endoscopic sinus surgery to achieve hemostasis and prevent wound adhesion. In the recent years, the variety of materials used for packing the nose has greatly increased. This study aimed to compare the pain during the removal of nasal packing and the cost of these three packing materials: fingerstall nasal packing, Vaseline gauze, and Merocel. Methods: A prospective study was performed to collect 30 chronic sinusitis patients who underwent endoscopic sinus surgery in our department from October 1996 through December 1997. The diagnosis and staging were according to sinus computer topography scan findings and the Kennedy staging system. Three postoperative nasal packing material, fingerstall, Vaseline gauze and Merocel, were used. The level of pain as rated on a scale during the removal of nasal packing and the cost of these three mate-rials were evaluated. Results: The pain level was the lowest with Merocel, and the highest with Vaseline gauze. The cost was highest for Merocel, and was much lower for Vaseline gauze and fingerstall packing. Conclusions: Vaseline gauze has the advantages of being inexpensive and highly viable, but it is uncomfortable during its removal. Merocel is comfort-able, with the disadvantage of its high expense. Fingerstall is an ideal nasal packing in endoscopic sinus surgery; it is comfortable, inexpensive, and practical.

並列關鍵字

fingerstall ； nasal packing ； endoscopic sinus surgery

國際替代計量

指套填塞法使用於鼻竇內視鏡手術

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