自体软骨移植整复单侧唇裂鼻畸形临床研究  

Clinical research on restitution of unilateral cleft lip nasal deformity by autologous cartilage transplantation

作　　者：陈从柏 解为慈 

机构地区：[1]天门市第一人民医院烧伤整形科,湖北天门431700

出　　处：《西南国防医药》2015年第8期867-869,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨自体软骨移植整复单侧唇裂鼻畸形的临床效果。方法以我院收治的25例单侧唇裂继发鼻畸形患者为研究对象,随机分成自体软骨移植整复组（A组,n=13）和硅胶-耳软骨复合体移植整复组（B组,n=12）。A组采用自体鼻中隔软骨或肋软骨移植整复单侧唇裂继发鼻畸形,B组采用硅胶-自体耳软骨复合体修复鼻畸形,记录两种材质植入后6～12个月内材料外露、鼻部感染、创口愈合、通气功能恢复时间及排斥反应情况等,对比两组术后满意度。结果 （1）A组治疗后无一例出现材料外露、鼻部感染及严重排斥反应情况;B组材料外露4例（33.3%）,鼻部感染1例1（8.4%）,严重排斥反应5例（41.7%）,两组在材料外露及排斥反应发生率对比上差异显著（P〈0.05）,在鼻部感染发生率对比上差异无统计学意义（P〉0.05）;（2）治疗后3个月,两组满意率对比差异无统计学意义（P〉0.05）;治疗后12个月内,A组满意率（92.31%）显著高于B组（50.00%）（P〈0.05）。结论自体软骨移植整复因自带软骨膜,存活率高、排斥反应少,可有效填充鼻部组织容量,起到良好的结构支撑作用,患者鼻翼软骨发育成熟后疗效最佳。Objective To discuss the clinical effects of autologous cartilage transplantation on the restitution of unilateral cleft lip nasal deformity. Methods Twenty five hospitalized patients with unilateral, cleft lip and secondary nasal deformity were chosen as the research objects and randomly divided into autologous cartilage transplantation group （group A, n=13） and silicone-auricular cartilage complex graft restitution group （group B, n=12）. Group A received the restitution by autogenous septal cartilage or rib cartilage transplantation. Group B received the restitution by silicone-auricular cartilage complex graft. Recording was made in the conditions like implantation material leakage, nasal infection, wound healing, ventilation function recovery time, rejection, etc. within 6 to 12 months after the implantation of those two materials. The postoperative satisfaction rates between the two groups were compared. Results （1） After the treatment, no case of implantation material leakage, nasal infection, or severe rejection occurred in group A. In group B, there were 4 cases of implantation material leakage （33.3%）, 1 case of nasal infection （8.4%）, and 5 ones of severe rejection （41.7%）. There were significant differences in the incidence of material leakage and rejection between the two groups （P 〈 0.05）. However, the difference in the incidence of nasal infection between the two groups was not significant （P 〉 0.05）. （2） Three months after treatment, there was no significant difference in the satisfaction rates between the two groups（P 〉 0.05）. The satisfaction rate in group A （92.31%） was significantly higher than that in group B （50.00%）. Conclusion Due to the self-bringing perichondrium, autologous cartilage transplantation has the advantages of high survival rate and less rejection. It can effectively fill the nasal tissue capacity and has a good structural supporting effect. Patients with mature nasal alar cartilage can achieve the best curative effects.

关 键 词：自体软骨 移植整复 单侧唇裂 鼻畸形 

分 类 号：R765.7[医药卫生—耳鼻咽喉科]