鼻中隔脓肿切开引流术

2016-03-06 MedSci MedSci原创

鼻中隔脓肿切开引流术

  [适应证]

  鼻部外伤或鼻中隔矫正术后致继发感染;形成鼻中隔脓肿,穿刺抽吸有脓液者(图1)。

图1 穿刺鼻中隔脓肿

  [手术器械]

  同下鼻甲部分切除术。

  [术前准备]

  同下鼻甲部分切除术。

  [麻醉]

  成人可用表面麻醉,儿童用全身麻醉。

  [手术方法]

  取半卧位,用刀夹在肿胀最突起处作约1cm长的垂直切口(图2),使脓液流出,并吸净脓血,探查脓腔,如有异物或坏死组织应即去除,置入橡皮引流后,鼻腔内堵塞止血。

图2 切开鼻中隔脓肿

  [注意事项]

  手术时不应在鼻中隔两侧均作切口,也应注意在作切口时不要将对侧粘软骨膜切穿,以免引起鼻中隔穿孔。

  [术后处理]

  1.每日用1%麻黄素棉片收敛鼻腔粘膜。如切口缩小,引流不畅,可以用鼻镊扩张切口,以保持引流通畅。炎症消退后切口会自行愈合。

  2.术后应用抗生素,并注意病人有无头痛、发热等症状,以防脓肿向上扩展,引起倾向并发症。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1984561, encodeId=861419845616a, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Thu Dec 29 16:25:00 CST 2016, time=2016-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157947, encodeId=954215e94791, content=垂直切口吗?实用耳鼻喉2书上说是平行鼻底的切口。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ab841985698, createdName=阿鼻道, createdTime=Thu Nov 24 21:51:38 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537243, encodeId=a114153e24300, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604169, encodeId=07181604169b6, content=<a href='/topic/show?id=edfe103399a6' target=_blank style='color:#2F92EE;'>#鼻中隔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103399, encryptionId=edfe103399a6, topicName=鼻中隔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1984561, encodeId=861419845616a, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Thu Dec 29 16:25:00 CST 2016, time=2016-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157947, encodeId=954215e94791, content=垂直切口吗?实用耳鼻喉2书上说是平行鼻底的切口。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ab841985698, createdName=阿鼻道, createdTime=Thu Nov 24 21:51:38 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537243, encodeId=a114153e24300, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604169, encodeId=07181604169b6, content=<a href='/topic/show?id=edfe103399a6' target=_blank style='color:#2F92EE;'>#鼻中隔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103399, encryptionId=edfe103399a6, topicName=鼻中隔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=)]
    2016-11-24 阿鼻道

    垂直切口吗?实用耳鼻喉2书上说是平行鼻底的切口。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1984561, encodeId=861419845616a, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Thu Dec 29 16:25:00 CST 2016, time=2016-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157947, encodeId=954215e94791, content=垂直切口吗?实用耳鼻喉2书上说是平行鼻底的切口。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ab841985698, createdName=阿鼻道, createdTime=Thu Nov 24 21:51:38 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537243, encodeId=a114153e24300, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604169, encodeId=07181604169b6, content=<a href='/topic/show?id=edfe103399a6' target=_blank style='color:#2F92EE;'>#鼻中隔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103399, encryptionId=edfe103399a6, topicName=鼻中隔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=)]
    2016-03-08 hunizi009
  4. [GetPortalCommentsPageByObjectIdResponse(id=1984561, encodeId=861419845616a, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Thu Dec 29 16:25:00 CST 2016, time=2016-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157947, encodeId=954215e94791, content=垂直切口吗?实用耳鼻喉2书上说是平行鼻底的切口。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ab841985698, createdName=阿鼻道, createdTime=Thu Nov 24 21:51:38 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537243, encodeId=a114153e24300, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604169, encodeId=07181604169b6, content=<a href='/topic/show?id=edfe103399a6' target=_blank style='color:#2F92EE;'>#鼻中隔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103399, encryptionId=edfe103399a6, topicName=鼻中隔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Mar 08 12:25:00 CST 2016, time=2016-03-08, status=1, ipAttribution=)]