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  止血宝油纱条下鼻甲术后填塞
 
 
 
止血宝油纱条下鼻甲术后填塞
曹辉,韩艳蓉
(大同市第二人民医院)
摘要:目的:比较两种填塞法在下鼻甲部分切除术后换药时的出血量及反应。方法:选取129例下鼻甲部分切除术患者,随机分为两组,一组采用常规凡士林纱条填塞,另一组采用中药止血宝凡士林纱条填塞,观察换药时出血量。结果:采用中药止血宝凡士林纱条填塞组,术后换药时出血量明显少于对照组。结论:采用中药止血宝纱条在下鼻甲部分切除术后填塞可明显降低术后换药时的出血量,值得临床推广。
关键词:下鼻甲;凡士林;止血宝
    1991年至2003年我院行双侧下鼻甲部分切除术129例,为减轻术后患者换药时的痛苦和减少出血,笔者对其中70例术后患者试用止血宝油纱条填塞鼻腔,经观察疗效满意,现报告如下。
1 资料与方法
1.1 一般资料
     本组129例均为慢性肥厚性鼻炎患者,男73例,女56例;年龄16-4岁,病程2a-23a。术前均测出凝血时间、查血小板计数,未见异常。
1.2 方法
     在局部麻醉下行双侧下鼻甲部分切除术,术毕将患者随即分为两组,A组(59例)以常规凡士林纱条填塞鼻腔,B组(70例)以止血宝凡士林纱条填塞鼻腔,术后24h换药对比两组的出血量
2 结果
    两组抽出纱条后鼻出血情况见表1。
表1 两组抽出纱条后鼻出血情况比较
组别
例数
出血<1ml
出血1ml-3ml
出血>3ml
A组
59
14
28
17
B组
70
63
6
1
合计
129
77
34
18
    由表1可见,A组17例抽出鼻腔纱条后鼻出血较多,较急,需再次以凡士林纱条填塞止血;B组抽出止血宝油纱条后鼻出血较少,出血量>1ml者7例,患者仅用小块止血宝油纱条贴敷创面即可。根据统计学处理,出血人数、出血量差异均有非常显著性(P<0.05)。
3 讨论
    下鼻甲部分切除术常规采用凡士林纱条填塞鼻腔,一般术后24h-48h全部抽出,下鼻甲术后创面较大,且下鼻甲血运丰富,不能缝合及电凝止血,多年来单纯的油纱条压迫填塞,使患者痛苦较大,换药时出血较多、较急,还需重新填塞。我们改用中药止血宝油纱条填塞,即把止血宝药粉撒在油纱条上予以填塞,而且填塞的油纱条数量亦较A组少。抽取纱条后多数患者基本上无出血,只有少数患者有少量的出血,再给予小块止血宝纱条贴敷创面,第2天换药取出即可,不需要重新填塞,可使惧怕手术后出血、换药痛苦的患者消除恐惧。
    止血宝吸取祖国传统医学之精髓,科学组方,其内含多种凝血因子激活物,可同时激活多个凝血因子,加速和放大了凝血反应,使凝血时间和凝血酶原时间缩短,同时提高血小板计数,降低毛细血管通透性和脆性,迅速完成止血过程,还有良好的双向调节功能,凝血而不淤血,将凝血作用和纤溶过程在动态环境中有机结合,用于手术后较大创面的出血,能迅速起到作用。本文资料表明,中药止血宝油纱条用于鼻甲手术后填塞,优于单纯的油纱条填塞,而且患者痛苦较小、出血少,未发现不良反应。
参考文献
[1]黄选兆,汪吉宝.实用耳鼻咽喉科学[M].北京:人民卫生出版社,1998:837-846
 
 
 

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日期:2010-8-25

 
 
 
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