儿童小耳畸形全扩张法耳郭再造术后效果与生活质量评估  

Evaluation of efficacy of expansion method for auricular reconstruction and quality of life in children with microtia

作　　者：王鹏[1,2] 何永静 朱礼昆[1] 杨蔚琪[1] 田昕芮[1] 卢凤艳 王继华 WANG Peng;HE Yongjing;ZHU Likun;YANG Weiqi;TIAN Xinrui;LU Fengyan;WANG Jihua(Department of Plastic Surgery,The Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院整形外科,云南昆明650101 [2]曲靖市第一人民医院皮肤医疗美容科,云南曲靖655000

出　　处：《中国美容整形外科杂志》2022年第4期204-208,共5页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的评估儿童先天性小耳畸形患者自体肋软骨耳郭再造术后效果及生活质量(quality of life,QOL)。方法收集2013年7月至2020年7月昆明医科大学第二附属医院整形外科在全扩张法耳郭再造术后发放两份问卷的256例患者。第一份问卷评估再造耳郭手术效果,涉及再造耳的大小、位置、颅耳角、亚单位结构等方面,总分100分,根据评分结果分为四个等级,即优、良、一般、差。第二份问卷为中文版格拉斯格儿童受益量表评分(glasgow children’s benefit inventory,GCBI),用于评价术后QOL的变化。得分为0表示QOL无变化,+100表示最大的改善,-100表示最大的恶化。并探讨再造耳手术效果和患者生活质量评分之间的关联性。结果共收回190份完整问卷,患儿手术效果评分:优69例(36.32%),良67例(35.26%),一般33例(17.37%),差21例(11.05%)。再造耳亚单位评分中,评分均值外耳轮最高(4.66分),耳屏最低(2.63分)。中文版GCBI量表得分均为正值,说明患儿术后QOL均得到不同程度的改善,其中在学习方面的改善最显著,其次是日常行为方面。相关性分析显示,再造耳手术效果与中文版GCBI总评分之间呈中等程度相关(r=0.57,P<0.01)。结论全扩张法联合自体肋软骨耳郭再造术可显著改善儿童的生活质量,并且更高质量的手术效果评分与更高的生活质量评分显著相关。Objective To assess the efficacy of auricular reconstruction using autologous costal cartilage and the quality of life in children with congenital microtia.Methods From July 2013 to July 2020,256 cases received two questionnaires after auricular reconstruction by expansion method in the Department of Plastic Surgery in the Second Affiliated Hospital of Kunming Medical University.The efficacy of auricular reconstruction was evaluated by the first questionnaire,including the size,location,cranioauricular angle and subunit structure of the reconstructed auricle.The total scores were 100 points.The reconstructed auricle was divided into 4 levels according to the scoring results,namely excellent,good,fair,and poor.The second questionnaire was the Chinese version of Glasgow Children’s Benefit Inventory(GCBI),which was used to evaluate changes in health-related quality of life after surgery.A score of 0 indicated that there was no change in health-related quality of life,+100 indicated the greatest improvement and-100 indicated the greatest negative impact.To explore the relationship between the efficacy of auricular reconstruction and scores of quality of life in patients.Results A total of 190 complete questionnaires were collected.The scoring results were excellent in 69 cases(36.32%),good in 67 cases(35.26%),fair in 33 cases(17.37%)and poor in 21 cases(11.05%).Among the scores of subunit structure of the reconstructed auricle,the average score of outer helix was the highest(4.66 points)and the tragus was the lowest(2.63 points).The scores of the Chinese version of GCBI were all positive,indicating that the quality of life after surgery was improved to different degrees.The improvement in learning was the most significant,followed by daily behavior.The correlation analysis showed a moderate correlation between the efficacy of auricular reconstruction and the total scores of the Chinese version of GCBI(r=0.57,P<0.01).Conclusion Expansion method combined with autologous costal cartilage for auricular reconstruction c

关 键 词：小耳畸形 耳郭再造 儿童 手术效果 生活质量 扩张法 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]