鼻中隔成形术后附加非吸收性鼻腔填塞的临床效用：系统评价与荟萃分析。
Clinical utility of additional non-absorbable nasal packing after septoplasty: a systematic review and meta-analysis.
文献信息
| PMID | 42867663 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Do Hyun Kim |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 327 Sosa-Ro, Bucheon-Si, Gyeonggi-Do, 14647, Seoul, Korea. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 本研究评估了在经鼻中隔缝合或鼻中隔夹板基础上附加非吸收性鼻腔填塞的临床效用。
方法： 采用两种分析框架进行系统评价与荟萃分析：鼻中隔缝合加非吸收性填塞对比单纯鼻中隔缝合或鼻中隔缝合加可吸收填塞，以及鼻中隔夹板加非吸收性填塞对比单纯鼻中隔夹板或单纯填塞。关注的结局包括术后出血、鼻中隔血肿、粘连/粘连形成、术后疼痛、头痛和睡眠障碍。
结果： 在基于缝合的分析中，附加非吸收性填塞并未显著减少术后出血或鼻中隔血肿形成，但与更高的头痛发生率（比值比[OR]：40.06，95%置信区间[CI]：16.05-99.99）和粘连形成率（OR：2.79，95% CI：1.00-7.77）相关。在基于夹板的分析中，附加填塞并未显著减少术后出血或总体粘连率。尽管夹板加填塞相比单纯填塞减少了粘连形成，但与单纯夹板治疗相比未观察到优势。附加填塞还与术后第1天和第7天显著更高的术后疼痛评分相关。
结论： 在已实现有效鼻中隔稳定后，鼻中隔成形术后附加非吸收性鼻腔填塞未提供一致的临床获益，并与术后不适增加相关。这些发现不支持在当代鼻中隔成形术后常规使用附加非吸收性鼻腔填塞。
英文摘要
PURPOSE: This study evaluated the clinical utility of additional non-absorbable nasal packing when combined with transseptal suturing or septal splints.
METHODS: A systematic review and meta-analysis was conducted using two analytical frameworks: septal suture plus non-absorbable packing versus septal suture alone or septal suture with absorbable packing, and septal splint plus non-absorbable packing versus septal splint alone or packing alone. Outcomes of interest included postoperative bleeding, septal hematoma, adhesion/synechia formation, postoperative pain, headache, and sleep disturbance.
RESULTS: In the suture-based analysis, additional non-absorbable packing did not significantly reduce postoperative bleeding or septal hematoma formation but was associated with higher rates of headache (odds ratio [OR]: 40.06, 95% confidence interval [CI]: 16.05-99.99) and synechia formation (OR: 2.79, 95% CI: 1.00-7.77). In the splint-based analysis, additional packing did not significantly reduce postoperative hemorrhage or overall adhesion rates. Although splint plus packing reduced adhesion formation compared with packing alone, no advantage was observed compared with splint-only treatment. Additional packing was also associated with significantly higher postoperative pain scores on postoperative days 1 and 7.
CONCLUSIONS: Additional non-absorbable nasal packing after septoplasty provides no consistent clinical benefit when effective septal stabilization has already been achieved and is associated with increased postoperative discomfort. These findings do not support the routine use of additional non-absorbable nasal packing following contemporary septoplasty.