安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2014年
10期
1359-1361
,共3页
鼻骨骨折%鼻中隔骨折偏曲%鼻内镜%成形%复位
鼻骨骨摺%鼻中隔骨摺偏麯%鼻內鏡%成形%複位
비골골절%비중격골절편곡%비내경%성형%복위
Nasal bone fracture%Nasal septum fracture deviation%Endoscopic sinus%Replacement surgery
目的：探讨鼻内镜下I期手术治疗外伤性鼻中隔骨折偏曲和鼻骨骨折的可行性及应用价值。方法选取经鼻骨CT扫描诊断为鼻骨骨折合并鼻中隔骨折偏曲并排除颅底骨折患者68例，34例鼻内镜下I期行鼻中隔成形术加鼻骨骨折闭合性复位术为治疗组，34例行单纯鼻骨骨折闭合性复位术（拒绝鼻内镜下开放手术者）作为对照组。结果治疗组34例，术后鼻外形矫正满意，鼻中隔基本居中，双侧鼻腔通气较好，随访1～12个月无鼻中隔血肿、穿孔，无鼻腔粘连等并发症。对照组术后有14例患者鼻腔通气欠佳，检查可见鼻中隔仍有骨折偏曲。结论鼻内镜下I期手术治疗外伤性鼻中隔骨折偏曲和鼻骨骨折安全有效，不会增加手术危险性和手术并发症，且同时解决鼻中隔矫正和鼻骨复位，避免了鼻中隔Ⅱ期手术，有较好的临床应用价值。
目的：探討鼻內鏡下I期手術治療外傷性鼻中隔骨摺偏麯和鼻骨骨摺的可行性及應用價值。方法選取經鼻骨CT掃描診斷為鼻骨骨摺閤併鼻中隔骨摺偏麯併排除顱底骨摺患者68例，34例鼻內鏡下I期行鼻中隔成形術加鼻骨骨摺閉閤性複位術為治療組，34例行單純鼻骨骨摺閉閤性複位術（拒絕鼻內鏡下開放手術者）作為對照組。結果治療組34例，術後鼻外形矯正滿意，鼻中隔基本居中，雙側鼻腔通氣較好，隨訪1～12箇月無鼻中隔血腫、穿孔，無鼻腔粘連等併髮癥。對照組術後有14例患者鼻腔通氣欠佳，檢查可見鼻中隔仍有骨摺偏麯。結論鼻內鏡下I期手術治療外傷性鼻中隔骨摺偏麯和鼻骨骨摺安全有效，不會增加手術危險性和手術併髮癥，且同時解決鼻中隔矯正和鼻骨複位，避免瞭鼻中隔Ⅱ期手術，有較好的臨床應用價值。
목적：탐토비내경하I기수술치료외상성비중격골절편곡화비골골절적가행성급응용개치。방법선취경비골CT소묘진단위비골골절합병비중격골절편곡병배제로저골절환자68례，34례비내경하I기행비중격성형술가비골골절폐합성복위술위치료조，34례행단순비골골절폐합성복위술（거절비내경하개방수술자）작위대조조。결과치료조34례，술후비외형교정만의，비중격기본거중，쌍측비강통기교호，수방1～12개월무비중격혈종、천공，무비강점련등병발증。대조조술후유14례환자비강통기흠가，검사가견비중격잉유골절편곡。결론비내경하I기수술치료외상성비중격골절편곡화비골골절안전유효，불회증가수술위험성화수술병발증，차동시해결비중격교정화비골복위，피면료비중격Ⅱ기수술，유교호적림상응용개치。
Objective To investigate the feasibility and application of intranasal endoscopic replacement surgery for patients with post-traumatic nasal bone fracture and nasal septum fracture deviation.Method 68 patients with history of nasal bone fracture were diag-nosed with nasal bone fracture accompanied with nasal septum fracture deviation excluding skull fracture by using nasal bone CT scan and di-vided into two groups.34 patients in treatment group were treated with intranasal endoscopic replacement surgery in nasal septum fracture de-viation and nasal bone fracture under local anesthesia while closed reduction of nasal bone fracture in nasal septum fracture deviation and na-sal bone fracture under local anesthesia was performed for other 34 in the control group.Result For treat group,nose shape correction is satisfactory,the nasal septum is almost centered and bilateral nasal ventilation is good.No nasal septum hematoma,perforation,nasal adhe-sions and other complications was found during follow-up sessions within 1 ~12 months.On the contrary,14 patients in control group still have poor nasal ventilation with nasal septum fracture deviation.Conclusion Intranasal endoscopic replacement surgery in nasal septum fracture deviation and nasal bone fracture is safe and effective;it does not increase the risk of surgery and its complications;it addresses the nasal bone fracture reset and nasal septum correction problem;it also avoids 2nd nasal septum surgery and has great clinical value.
