内镜辅助下治疗与头皮冠状切口手术在治疗颧骨复合体骨折中的疗效及并发症对比研究  

Comparison of Curative Effects and Complications between Endoscope-assisted Treatment and Scalp Coronal Incision for Zygomatic Complex Fractures

作　　者：孙德平[1] 吴武[1] 温胜[1] 梁晓宇[1] 陈裕仁 张宏[1] 

机构地区：[1]达县人民医院耳鼻咽喉-头颈外科,四川达州635000

出　　处：《华西医学》2015年第12期2217-2221,共5页West China Medical Journal

摘　　要：目的比较内镜辅助下治疗与头皮冠状切口手术在颧骨复合体骨折中的疗效及并发症。方法将2008年1月-2014年5月收治的50例颧骨复合体骨折患者完全随机分为内镜辅助下治疗组(试验组,30例)及头皮冠状切口术式组(对照组,20例)。试验组在内镜辅助下行骨折功能复位并固定骨折线;对照组行头皮内冠状切口,行骨折功能复位内固定术。根据体格检查及CT复查评估并对比两组患者的疗效,同时对手术并发症进行对比分析。结果试验组疗效Ⅰ级24例(80.0%),Ⅱ级5例(16.7%),Ⅲ级1例(3.3%);对照组疗效Ⅰ级16例(80.0%),Ⅱ级3例(15.0%),Ⅲ级1例(5.0%);两组疗效差异无统计学意义(P>0.05)。试验组无患者发生并发症,对照组发生面神经损伤4例(20.0%),脱发5例(25.0%),颞部凹陷4例(20.0%),头皮血肿5例(25.0%);对照组各并发症发生率均高于试验组,差异有统计学意义(P<0.05)。结论内镜辅助下治疗颧骨复合体骨折与传统的头皮冠状切口术式疗效确切无差异,但减少了手术的并发症,是一种微创和符合美学的手术方式。Objective To compare the curative ef ects and complications between endoscope-assisted treatment and scalp coronal incision for zygomatic complex fractures. Methods Fit y zygomatic complex fracture patients treated between January 2008 to May 2014 were randomly divided into trial group（n=30） treated through endoscope-assisted procedure and control group（n=20） treated through scalp coronal incision. In the trial group, functional reduction and i xation of the fractures under endoscope were performed, and the control group was treated with coronal incision and internal fixation of the fractures. After the operation, all the patients were evaluated on the effects and complications through physical examination and CT review. Results The number of grade- Ⅰ,- Ⅱ and- Ⅲ curative effects were respectively 24（80.0%）, 5（16.7%）, and 1（3.3%） in the trial group, while those numbers in the control group were respectively 16（80.0%）, 3（15.0%）, and 1（5.0%）. h ere was no signii cant dif erence in the curative ef ects between the two groups（P〉0.05）. There were no cases of complications in the trial group, but there were 4 cases（20.0%） of facial nerve injury, 5 cases（25.0%） of hair loss, 4 cases（20.0%） of temporal sag, and 5 cases（25.0%） of scalp hematoma in the control group. h e complication rate in the control group was signii cantly higher than that in the trial group（P〈0.05）. Conclusion While the curative ef ects between endoscope-assisted treatment and scalp coronal incision for zygomatic complex fractures are not significantly different, endoscope-assisted technology can reduce the complications of the operation, which is a minimally invasive surgery and can promote good aesthetic appearance.

关 键 词：内镜 颧骨骨折 外科手术 最小侵入性 美容 

分 类 号：R782.4[医药卫生—口腔医学]