鼻成形术中部分自体肋软骨填充鼻尖对肥大鼻尖部外形的改善作用  

Improving effects of partial autologous rib cartilage filling in rhinoplasty on the shape of nasorostral hypertrophy

作　　者：魏亚锋 李永熙 WEI Ya-feng;LI Yong-xi(Department of Plastic Surgery,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]宝鸡市人民医院整形美容外科

出　　处：《海南医学》2019年第11期1404-1407,共4页Hainan Medical Journal

摘　　要：目的探究鼻成形术中部分自体肋软骨填充鼻尖对肥大鼻尖部外形的改善作用。方法回顾性分析2017年3月至2018年7月宝鸡市人民医院整形美容外科84例行鼻成形术治疗的鼻尖肥大患者的临床资料,根据其手术方式分为自体肋软骨填充组40例(观察组)及硅胶填充组44例(对照组)。比较两组患者术前及术后7 d创伤指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]、术前及术后90 d鼻尖部外形数据(鼻长、鼻尖高度、鼻尖两顶间距离),并比较两组患者鼻部创口愈合情况和患者满意度状况。结果术后7 d时,两组患者的血清hs-CRP、TNF-α水平均较术前升高[观察组(15.22±2.87) mg/L vs (18.24±3.06) mg/L、(1.43±0.24)μg/L vs (1.98±0.28)μg/L,对照组(14.96±3.04) mg/L vs (17.69±3.11) mg/L、(1.39±0.22)μg/L vs (1.91±0.26)μg/L],差异均有统计学意义(P<0.05),但两组组间比较差异均无统计学意义(P>0.05);两组患者手术前后组内及组间鼻长比较差异均无统计学意义(P>0.05);术后90 d时,两组患者的鼻尖高度均较术前升高[观察组(16.12±2.36) mm vs (22.53±2.69) mm、对照组(16.23±2.44) mm vs(22.15±2.61) mm],鼻尖两顶间距离则较术前降低[观察组(7.19±0.51) mm vs (5.38±0.42) mm、对照组(7.11±0.49) mm vs(5.29±0.44) mm],差异均有统计学意义(P<0.05),但两组组间比较差异均无统计学意义(P>0.05);观察组患者的鼻部创口愈合时间和并发症总发生率分别为(8.41±1.89) d和5.00%,均低于对照组的(14.36±2.65) d和20.45%,差异均有统计学意义(P<0.05),观察组患者满意度明显优于对照组,差异有统计学意义(P<0.05)。结论自体肋软骨填充鼻尖鼻成形术能有效改善肥大鼻尖部外形,且术后愈合较快,患者满意度较高,整形近期效果显著。Objective To explore the effects of partial autologous rib cartilage filling in rhinoplasty on improving the shape of nasorostral hypertrophy. Methods The clinical data of 84 patients with nasorostral hypertrophy who underwent rhinoplasty in department of Plastic Surgery, Baoji People’ s Hospital from March 2017 to July 2018 were retrospectively analyzed. According to their surgical methods, the patients were divided into autologous rib cartilage filling group(observation group, 40 cases) and silica gel filling group(control group, 44 cases). The trauma indexes(hypersensitive C-reactive protein [hs-CRP], tumor necrosis factor-α[TNF-α]) before operation and at 7 d after operation, as well as nasorostral shape data(nose length, nasorostral height, distance between two tops of nose tip) before operation and at90 d after operation, were compared between the two groups, and the nasal wound healing and patients’ satisfaction were compared between the two groups. Results At 7 d after operation, the levels of serum hs-CRP and TNF-α in the two groups were increased compared with those before operation(P<0.05): hs-CRP(15.22±2.87) mg/L vs(18.24±3.06) mg/L, TNF-α(1.43 ± 0.24)μ g/L vs(1.98 ± 0.28)μ g/L for the observation group;hs-CRP(14.96 ± 3.04) mg/L vs(17.69±3.11) mg/L, TNF-α(1.39±0.22)μg/L vs(1.91±0.26)μg/L for the control group, but there were no significant differences between the two groups(P>0.05). There was no significant difference in the nose length within-groups before and after operation and between-groups(P>0.05):(42.74 ± 4.05) mm vs(43.11 ± 4.32) mm in the observation group;(41.96 ± 4.11) mm vs(42.51 ± 4.27) mm in the control group. At 90 d after operation, the nasorostral height in the two groups was increased compared with that before operation(P<0.05):(16.12±2.36) mm vs(22.53±2.69) mm in the observation group;(16.23±2.44) mm vs(22.15±2.61) mm in the control group. The distance between two tops of nose tip was reduced compared with that before operation(P<0.05):(7.19 ± 0.51) mm

关 键 词：鼻尖肥大 鼻成形术 自体肋软骨 假体 创伤 外形 愈合 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]