庞长安

[摘要] 目的 比较鼻内镜鼻中隔黏膜下切除术和鼻内镜改良鼻中隔成形术治疗鼻中隔偏曲术后并发症的发生情况。 方法 整群收集2010年4月—2015年1月在该院耳鼻喉科住院治疗的鼻中隔偏曲患者384例，随机分为鼻中隔黏膜下切除术组（A组） 191例和改良鼻中隔成形术组（B组）193例，A组采用鼻内镜鼻中隔黏膜下切除术治疗，B组采用鼻内镜改良鼻中隔成形术治疗，比较两组术后并发症发生情况。 结果 A组鼻中隔摆动、鼻中隔穿孔、鼻小柱退缩、鼻梁塌陷的发生率明显高于B组（P<0.05）。10例鼻中隔穿孔患者均进行再次修补手术治疗，其中2例修补失败。26例鼻中隔摆动患者由于无明显不适，未给予特殊治疗。5例鼻小柱退缩、8例鼻梁塌陷患者均采用异体鼻中隔软骨修复术治疗，随访2年后无明显变形。 结论 鼻内镜下改良鼻中隔成形术具有创伤小，并发症少等优势，值得临床推广应用。

[关键词] 鼻中隔偏曲；腹腔镜；鼻中隔黏膜下切除术；改良鼻中隔成形术

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）10（a）-0058-02

Comparatively Study on the Postoperative Complications of Two Kinds of Nasal Septum Surgery

PANG Chang-an

Department of ENT， Zhengzhou Seventh People's Hospital， Zhengzhou， Henan Province， 454000 China

[Abstract] Objective To compare the postoperative incidence of complications between endoscopic submucous resection of nasal septum and endoscopic modified nasal septum plasty for the treatment of deviation of nasal septum. Methods 384 patients with deviation of nasal septum underwent hospitalization in Department of ENT of our hospital between April 2010 and January 2015 were selected and randomly divided into submucous resection of nasal septum group（group A， 191 cases） and modified nasal septum plasty group（group B， 193 cases）. Patients in group A were treated by endoscopic submucous resection of nasal septum， and those in group B were treated by endoscopic modified nasal septum plasty. And the incidence of complications was compared between the two groups. Results The incidences of nasal septum swing， perforation of nasal septum， nasal columella retreat， bridge collapse in group A were significantly higher than those in group B （P<0.05）. 10 patients with nasal septum perforation were treated by repair operation again， of them， 2 patients were failed. 26 patients with nasal septum swing were not given special treatment because of no obvious discomfort. 5 patients with nasal columella retreat and 8 patients with bridge collapse were treated by allograft nasal septal cartilage repair with no obvious deformation during 2-year follow-up. Conclusion Endoscopic modified nasal septum plasty has the advantages of less trauma and complications， which is worthy of clinical application and promotion.

[Key words] Deviation of nasal septum； Laparoscope； Submucous resection of nasal septum； Modified nasal septum plasty

鼻中隔偏曲通常会导致鼻塞、头痛、反复鼻出血等症状。目前，其最有效的治疗手段是鼻中隔矫正手术。近年来，鼻内镜已在临床上得到了广泛的应用，最常见的两种术式为鼻内镜鼻中隔黏膜下切除术和鼻内镜改良鼻中隔成形术，两种术式术后均存在程度不同的并发症，这些并发症均会影响患者术后恢复[1]。该研究对2010年4月—2015年1月间该院收治的384例患者进行随机分组，分别采用上述两种手术进行治疗，观察患者术后并发症发生情况，旨在通过了解两种术式并发症的差异，为鼻中隔偏曲的治疗提供参考，现报道如下。

1 资料与方法

1.1 一般资料

整群收集在该院耳鼻喉科住院治疗的鼻中隔偏曲患者384例，根据随机数字表法将患者分为鼻中隔黏膜下切除术组（A组）采用鼻内镜鼻中隔黏膜下切除术治疗191例，其中男124例，女67例；……