导航辅助美容切口复位内固定治疗单侧B型颧骨骨折的疗效  

Efficacy of navigation-assisted cosmetic incision for reduction and internal fixation in treating unilateral type B zygomatic fracture

作　　者：江灿洋 林月蓉 林李嵩[1] 黄建平[1] 江燕[1] 阮鑫 黄立[1] Jiang Canyang;Lin Yuerong;Lin Lisong;Huang Jianping;Jiang Yan;Ruan Xin;Huang Li(Department of Oral and Maxillofacial Surgery,Facial Reconstruction Institute,First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,China;Department of Anesthesiology,Anesthesiology Research Institute,First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院口腔颌面外科,福建医科大学面部整复与重建研究室,福建省颌面医学中心,福州350005 [2]福建医科大学附属第一医院麻醉科,福建医科大学麻醉学研究所,福州350005

出　　处：《中华创伤杂志》2022年第1期47-53,共7页Chinese Journal of Trauma

基　　金：福建省卫生健康青年科研课题(2020QNB023);福建省卫计委创新课题(2018-CX-27);福建医科大学启航基金(2018QH1076)。

摘　　要：目的探讨导航辅助美容切口复位内固定治疗单侧B型颧骨骨折的临床疗效。方法采用回顾性队列研究分析2018年1月至2019年12月福建医科大学附属第一医院收治的35例单侧B型颧骨骨折患者临床资料,其中男20例,女15例;年龄5~62岁[(38.7±11.3)岁]。17例采用外科导航技术辅助美容切口复位内固定治疗(导航组),18例采用常规经验性美容切口复位内固定治疗(常规组)。分别测量术后1周时双侧颧骨CT水平轴位上骨性颧突点的长度(颧突度)、颧颞点的宽度(前面宽度),比较两组患侧和健侧骨性颧突度差值、骨性前面宽度差值的绝对值;比较两组术后半年时患者满意度及下睑外翻、切口感染、面神经损伤等并发症情况。结果患者均获随访6~24个月[(9.3±1.2)个月]。术后1周时导航组骨性颧突度绝对差值为0.60(0.25,0.85)mm,常规组为0.75(0.20,1.98)mm(P>0.05)。导航组骨性前面宽度绝对差值为(0.37±0.11)mm,常规组为(2.47±0.63)mm(P<0.01)。术后半年时导航组客观评价、主观评价术后患者满意度均优于常规组(P均<0.05)。术后半年导航组出现下睑外翻1例,切口感染1例;常规组出现面神经损伤1例,切口感染2例。导航组并发症发生率[12%(2/17)]与常规组[17%(3/18)]比较,差异无统计学意义(P>0.05)。结论对于单侧B型颧骨骨折,与常规经验性美容切口复位内固定比较,导航辅助美容切口复位内固定治疗可更精确地恢复前面部宽度、提高患者满意度。Objective To analyze the clinical effect of navigation-assisted cosmetic incision for reduction and internal fixation in treating unilateral B-type zygomatic fracture.Methods A retrospective cohort study was performed on clinical data of 35 patients with unilateral type B zygomatic fracture treated from January 2018 to December 2019 in First Affiliated Hospital of Fujian Medical University.There were 20 males and 15 females at age range of 5-62 years[(38.7±11.3)years].Navigation-assisted cosmetic incision for reduction and internal fixation was performed for 17 patients(navigation group),and empirical incision to reduction and internal fixation was performed for 18 patients(convention group).The length of bony zygomatic process(zygomatic process)and width of zygomatic temporal point(frontal width)of the bilateral zygomatic bone were measured on the horizontal axis of CT at 1 week after operation.The absolute values of the difference of bony zygomatic process degree and frontal bony width between affected side and the healthy side were compared between the two groups.The patients′satisfaction and occurrence of complications such as lower eyelid ectropion,incision infection and facial nerve injury were compared between the two groups at half a year after operation.Results All patients were followed up for 6-24 months[(9.3±1.2)months].The absolute difference of bony zygomatic process was 0.60(0.25,0.85)mm in navigation group,and was 0.75(0.20,1.98)mm in convention group(P>0.05).The absolute difference of frontal bony width was(0.37±0.11)mm in navigation group,and was(2.47±0.63)mm in convention group(P<0.01).Satisfaction rates by both objective evaluation and subjective evaluation in navigation group were better than that in convention group at half a year after operation(both P<0.05).Navigation group showed lower eyelid ectropion in 1 patient and incision infection in 1 patient.Convention group showed facial nerve injury in 1 patient and incision infection in 2 patients.There was no significant difference in t

关 键 词：颧骨骨折 外科手术 计算机辅助 导航 

分 类 号：R782.4[医药卫生—口腔医学]