山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (5): 58-60.doi: 10.6040/j.issn.1673-3770.0.2016.153

• 睡眠呼吸障碍性疾病 • 上一篇    下一篇

塞纳斯凝胶在鼻息肉伴睡眠呼吸障碍成年患者鼻内镜术中的应用

王海鹏1,徐会娟1,张秀芳1,王惠忠1,李延忠2   

  1. 1.淄博市中心医院耳鼻咽喉头颈外科, 山东 淄博 255031;
    2.山东大学齐鲁医院耳鼻咽喉科/卫生部耳鼻咽喉科学重点实验室, 山东 济南 250012
  • 收稿日期:2016-04-05 出版日期:2016-10-20 发布日期:2016-10-20
  • 通讯作者: 张秀芳. E-mail:qlyyzxf@sina.com E-mail:whpzbzxyy@163.co
  • 作者简介:王海鹏. E-mail:whpzbzxyy@163.co

The application of Sinus Jel in adult patients of nasal polyps with sleep-disordered breathing.

WANG Haipeng1, XU Huijuan1, ZHANG Xiufang1, WANG Huizhong1, LI Yanzhong   

  1. 1. Department of Otolaryngology &Head and Neck Surgery, Zibo Central Hospital, Zibo 255031, Shandong, China;2. Department of Otolaryngology, Qilu Hospital of Shandong University / Key Laboratory of Otorhinolaryngology of Health Ministry, Jinan 250012, Shandong, China
  • Received:2016-04-05 Online:2016-10-20 Published:2016-10-20

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摘要： 目的 为选择更适合鼻内镜术临床应用的填塞材料,总结归纳塞纳斯凝胶在慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)引起的睡眠呼吸障碍(SDB)患者行鼻内镜术中的应用情况,探讨SDB患者与非SDB患者应用塞纳斯凝胶后其舒适度的差异。 方法 双侧CRSwNP成人患者216例施行鼻内镜手术,其中伴SDB 156例,不伴SDB 60例。分为4个组,其中A组为不伴SDB患者术中填塞塞纳斯凝胶60例、B组为伴SDB患者术中填塞塞纳斯凝胶组56例, C组为伴SDB患者术中填塞纳吸棉组47例, D组为伴SDB患者术中填塞医用膨胀海绵组53例。采用视觉模拟评分法(VAS)对其鼻腔反应进行比较。 结果 A组和B组比较,塞纳斯凝胶在头痛、鼻痛及术后出血三方面差异有统计学意义(P<0.05),SDB患者在这三方面更不耐受。B组与C组比较,在头痛、鼻痛、鼻塞感、流泪四方面差异有统计学意义(P<0.05),塞纳斯凝胶优于纳吸棉。B组与D组比较,在头痛、鼻痛、鼻塞感、流泪、吞咽障碍、术后出血6个方面差异均有统计学意义(P<0.05),但临床意义不同,在术后出血方面塞纳斯凝胶组的效果虽差于医用膨胀海绵组,但仍可接受,其余方面塞纳斯凝胶明显优于膨胀海绵。 结论 塞纳斯凝胶是更适合于临床应用的填塞材料,能为患者带来更高的术后舒适度。另外SDB能加重患者头痛、鼻痛和术后出血症状,可能与长期缺氧致炎症反应较重有关。

关键词: 鼻息肉, 塞纳斯凝胶, 鼻腔填塞, 内镜手术, 睡眠呼吸障碍

Abstract: Objective To explore whether PureRegen Gel Sinus is a suitable nasal packing material for patients with sleep-disordered breathing(SDB)caused by chronic rhinosinusitis plus nasal polys(CRSwNP). Methods A total of 216 CRSwNP cases including 156 SDB and 60 non-SDB cases were divided into 4 groups. Group A(60 non-SDB cases)and group B(56 SDB cases)were treated with PureRegen Gel Sinus after nasal sinus surgery. Group C included 47 SDB cases treated with Nasopore. Group D included 53 SDB cases treated with Medical Sponge. The nasal reactions of the 4 groups were compared with Visual Analogue Scale(VAS). Results There were significant differences in headache, rhinalgia and postoperative bleeding between group A and B(P<0.05). Patients with SDB were more intolerant to these complications. There were statistical differences in headache, rhinalgia, rhinobyon and lacrimation between group B and C(P<0.05). PureRegen Gel Sinus was was superior to Nasopore. There were statistical differences in headache, rhinalgia, rhinobyon, lacrimation, dysphagia and postoperative bleeding between group B and D(P<0.05). PureRegen Gel Sinus was no better than medical sponge in dealing with postoperative bleeding, but it was still acceptable. PureRegen Gel Sinus was superior to medical sponge in other aspects. Conclusion PureRegen Gel Sinus is more suitable for clinical practice as a packing material. In addition, SDB can worsen headache, rhinalgia and postoperative bleeding, which may be associated with inflammation resulted from long-term oxygen depletion.

Key words: Nasal packing, PureRegen Gel Sinus, Sleep-disordered breathing, Endoscopic sinus surgery, Nasal polyps

中图分类号: 

  • R766.7
[1] Young T, Palta M, Dempsey J, et al. The occurrence of sleep disordered breathing among middle age adults[J]. N Engl J Med, 1993, 328(12):1230-1235.
[2] Ancolii S, Kripke D F, Klauber M R, et al. Sleep disordered breathing in community dwelling elderly[J]. Sleep, 1991, 14(6):486-95.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 慢性鼻-鼻窦炎诊断和治疗指南(2012, 昆明)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(2):92-94.
[4] Vaiman M, Evitar E, Segal S. Effectiveness of secondgeneration fibrin glue endonasal operations[J]. Otolaryngal Head Neck Surg, 2002, 126(4):388-391.
[5] 陈秀梅, 张庆泉, 栾信庸. 三种鼻腔填塞材料在鼻内镜手术中的疗效比较[J]. 山东大学耳鼻喉眼学报, 2006, 20(5):438-440. CHEN Xiumei, ZHANG Qingquan, LUAN Xinyong. Effect of three nasal packing materials in functional endoscopic sinus surgery[J]. J Otolaryngol Ophthalmol Shandong Univ, 2006, 20(5):438-440.
[6] Sabato R, Guido P, Salerno F G, et al. Airway inflammation in patients affected by obstructive Sleep apnea[J]. Monaldi Arch Chest Dis, 2006, 65(2):102-105.
[7] Burioka N, Koyanagi S, Fukuoka Y, et al. Influence of intermittent hypoxia on the signal transduction pathways to inflammatory response and circadian clock regulation[J]. Life Sci, 2009, 85(9-10):372-378.
[8] 王海鹏, 赵允沛, 张增, 等. 多导睡眠监测和头颅侧位片在儿童睡眠呼吸障碍诊治中的应用[J]. 临床耳鼻咽喉科头颈外科杂志, 2014, 28(24):1982-1985. WANG Haipeng, ZHAO Yunpei, ZHANG Zeng, et al. Application research of polysomnography and lateral cephalometric radiographs in the diagnosis and treatment of sleep-disordered breathing in children[J]. Clin J Otorhinolarynol Head Neck Surg, 2014, 28(24):1982-1985.
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