射频联合明胶海绵隔离治疗鼻腔粘连疗效观察
|
摘要
目的探讨射频联合明胶海绵隔离作为治疗鼻腔粘连的疗效,寻求一种更好的治疗鼻腔粘连的方法。方法回顾性总结、分析84例(125侧)射频联合明胶海绵隔离治疗鼻腔粘连病例,治疗时用射频分离粘连组织并电凝创面,用稍大于创面的一至多层明胶海绵安放于粘连分离处,分隔两侧创面,2周复诊。结果 123侧鼻腔粘连一次性治愈,2侧新的粘连形成,再次分离,随访6个月无复发。其中鼻塞症状完全解除93侧,好转22侧,无效10侧,脓涕症状解除48侧,头昏、头痛症状解除64例。结论射频分离鼻腔粘连并用明胶海绵隔离粘连处治疗鼻腔粘连方法简单易行,门诊即可操作;治疗时创伤小、基本不出血;治疗后不用填塞、痛苦少;且本术式成本低,效果肯定,术后随访少,病员易于接受,可以推广使用。
Objective To observe the effect of treating nasal adhesion using radio frequency(RF) and gelatin sponge together to seek a better way for it. Methods Retrospectively summarized and analysed 84 patients(125 cases) whose nasal adhesion were treated by the way mentioned above. We used RF to seperate the nasal adhesion and used electricity to coagulate the wound,after that we placed multilayer gelatin sponge which is wider than the wound in the separate parts. Every patient returned a visit after two weeks. Results By this way,123 cases of nasal adhesion were cured completely, 2 cases of them formed new adhesion which were once again separated and there was no recurrence after 6 months' follow-up. 93 cases' nasal congestion completely removed and 22 cases' got improvement except there was no effect for 10 cases. Meanwhile, 48 cases' symptom of streaming disappeared and the headache of 64 patients disappeared. Conclusion Using RF and gelatin sponge together to treat nasal adhesion is simple and feasible for outpatient service. Not only for the trauma is small, no bleeding basicly, no need for nasal packing and less painful but also for its low cost, certain curative effect and less follow-up, it can be accepted by patients and suitable to be popularized and applied.
Objective To observe the effect of treating nasal adhesion using radio frequency(RF) and gelatin sponge together to seek a better way for it. Methods Retrospectively summarized and analysed 84 patients(125 cases) whose nasal adhesion were treated by the way mentioned above. We used RF to seperate the nasal adhesion and used electricity to coagulate the wound,after that we placed multilayer gelatin sponge which is wider than the wound in the separate parts. Every patient returned a visit after two weeks. Results By this way,123 cases of nasal adhesion were cured completely, 2 cases of them formed new adhesion which were once again separated and there was no recurrence after 6 months' follow-up. 93 cases' nasal congestion completely removed and 22 cases' got improvement except there was no effect for 10 cases. Meanwhile, 48 cases' symptom of streaming disappeared and the headache of 64 patients disappeared. Conclusion Using RF and gelatin sponge together to treat nasal adhesion is simple and feasible for outpatient service. Not only for the trauma is small, no bleeding basicly, no need for nasal packing and less painful but also for its low cost, certain curative effect and less follow-up, it can be accepted by patients and suitable to be popularized and applied.
引文
[1]许庚,李源.谢民强,等.功能性内窥镜鼻窦手术后术腔粘膜转归阶段的划分及处理原则[J].中华耳鼻咽喉科杂志,1999,34(5):302-305.
[2]周永,唐安洲,蓝新海,等.鼻咽癌放疗后鼻腔粘连的治疗[J].临床耳鼻咽喉科杂志,2000,14(9):398-399.
[3]布荣霞,崔江,陈金中,等.鼻内镜术后鼻腔粘连的临床分析[J].中国内镜杂志,2008,14(6):140-141,143.
[4]韩德民,周兵.鼻内镜外科学[M].北京:人民卫生出版社,2001:215-216.
[5]王翔,陶苏华,吴斌.鼻内镜手术后鼻腔粘连的探讨[J].黑龙江医学,2008,35(6):55-56.
[6]凌天鸿.射频治疗鼻出血115例体会[J].右江民族医学院学报,2009,36(3):452-453.
[7]胡碧波.鼻内镜下射频治疗鼻腔粘连32例报告[J].医学创新研究,2007,4(5):76-77.
[8]黄宇勇,晓华.不同鼻腔填塞物对鼻内镜术后伤口疼痛和止血效果的临床观察[J].中国耳鼻咽喉颅底外科杂志,2006,11(4):308-309.
[9]张贤,甄泽年,杨育坚.明胶海绵夹乳胶片隔离法治疗鼻中隔鼻甲粘连54例[J].临床耳鼻咽喉科杂志,2001,15(5):230.
[10]何甫成,陈特锐,崔江,等.鼻内镜术后鼻腔鼻窦填塞材料的对比研究[J].临床耳鼻咽喉头颈外科杂志,2007,2l(6):276-277.
[11]陈苏桂,高雪萍.不同止血材料在鼻出血填塞中的应用及其生物学特性[J].中国组织工程研究与临床康复,2008,11(32):6358-6360.
[12]杜修勇,方争胜.明胶海绵夹层法在防治鼻腔粘连中的应用[J].卫生职业教育,2001,19(7):64.
[13]聂军,张汉武,黎犁,等.可吸收性明胶海绵在鼻腔粘连中的应用[J].中国耳鼻咽喉颅底外科杂志,2010,15(4):306-307.
[2]周永,唐安洲,蓝新海,等.鼻咽癌放疗后鼻腔粘连的治疗[J].临床耳鼻咽喉科杂志,2000,14(9):398-399.
[3]布荣霞,崔江,陈金中,等.鼻内镜术后鼻腔粘连的临床分析[J].中国内镜杂志,2008,14(6):140-141,143.
[4]韩德民,周兵.鼻内镜外科学[M].北京:人民卫生出版社,2001:215-216.
[5]王翔,陶苏华,吴斌.鼻内镜手术后鼻腔粘连的探讨[J].黑龙江医学,2008,35(6):55-56.
[6]凌天鸿.射频治疗鼻出血115例体会[J].右江民族医学院学报,2009,36(3):452-453.
[7]胡碧波.鼻内镜下射频治疗鼻腔粘连32例报告[J].医学创新研究,2007,4(5):76-77.
[8]黄宇勇,晓华.不同鼻腔填塞物对鼻内镜术后伤口疼痛和止血效果的临床观察[J].中国耳鼻咽喉颅底外科杂志,2006,11(4):308-309.
[9]张贤,甄泽年,杨育坚.明胶海绵夹乳胶片隔离法治疗鼻中隔鼻甲粘连54例[J].临床耳鼻咽喉科杂志,2001,15(5):230.
[10]何甫成,陈特锐,崔江,等.鼻内镜术后鼻腔鼻窦填塞材料的对比研究[J].临床耳鼻咽喉头颈外科杂志,2007,2l(6):276-277.
[11]陈苏桂,高雪萍.不同止血材料在鼻出血填塞中的应用及其生物学特性[J].中国组织工程研究与临床康复,2008,11(32):6358-6360.
[12]杜修勇,方争胜.明胶海绵夹层法在防治鼻腔粘连中的应用[J].卫生职业教育,2001,19(7):64.
[13]聂军,张汉武,黎犁,等.可吸收性明胶海绵在鼻腔粘连中的应用[J].中国耳鼻咽喉颅底外科杂志,2010,15(4):306-307.