多孔高密度聚乙烯材料联合激光打孔硅胶假体在鼻修复中的疗效评价与并发症处理  

Efficacy evaluation and complications treatment of PPE combined with laser perforated silicone prosthesis in rhinoplasty

作　　者：张斐 谢红炬 左俊 ZHANG Fei;XIE Hongju;ZUO Jun(Department of Cosmetic and Plastic Surgery,The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院美容整形科,湖南长沙410007 [2]海南医学院附属第二医院整形美容科,海南海口571000 [3]新疆医科大学附属第一医院整形外科,新疆乌鲁木齐830000 [4]南华大学附属第二医院手足显微整形外科,湖南衡阳421000

出　　处：《中国美容整形外科杂志》2022年第10期581-585,共5页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：湖南省自然科学基金青年基金(2021JJ40487);海南省高等学校重点科研项目(HnkyJJ2021ZD-17)。

摘　　要：目的评估多孔高密度聚乙烯(porous high-density polyethylene,PPE)联合激光打孔硅胶假体在鼻修复术中的临床应用效果及并发症。方法自2019年11月至2021年9月,南华大学附属第二医院手足显微整形外科分别纳入50例接受上述两种材料联合使用(PPE组)和42例采用自体肋软骨联合打孔硅胶假体(对照组)行鼻修复手术的患者,开放术式重建鼻尖支架,打孔硅胶抬高鼻背。定期随访拍照,客观评估PPE组患者鼻部美学指标,并对照分析两组患者的主观满意度和术后常见的并发症。结果PPE组和对照组满意率分别为86.0%(43/50)和83.3%(35/42),差异无统计学意义(P>0.05)。PPE组术后鼻唇角较术前增加(P<0.05),远期随访变化无统计学意义(P>0.05);鼻尖突出度较术前增加(P<0.05),术后1个月有轻微降低(P<0.05),但3个月后变化无统计学意义(P>0.05)。两组患者术后并发症的构成比差异无统计学意义(P>0.05)。结论多孔高密度聚乙烯材料联合激光打孔硅胶假体在鼻修复术中可提供良好的生物力学支撑和生物相容性,但仍需要加强术后护理并积极预防和处理并发症。Objective To evaluate the clinical efficacy and complications of porous high-density polyethylene(PPE)combined with perforated silicone prosthesis(PSP)in rhinoplasty.Methods From November 2019 to September 2021,50 patients received PPE combined with PSP treatment(PPE group)and 42 patients received autologous costal cartilage combined with PSP treatment(control group)were involved in this study.The nasal tip stent was reconstructed through open access and PSP was used to raise the nasal dorsum.Regular photos were taken to objectively evaluate the nasal aesthetics.The subjective satisfaction and common postoperative complications in both groups were compared and analyzed during the follow-up.Results The satisfaction rate was 86%(43/50)in the PPE group and83.3%(35/42)in the control group(P>0.05).The postoperative nasolabial angle was significantly increased compared with that before operation(P<0.05),there was no statistical significance in long-term follow-up(P>0.05).The nasal tip protrusion was significantly increased after operation(P<0.05)and slightly decreased at 1 month after operation(P<0.05).No significant change was observed after 3 months(P>0.05).There was no significant difference in postoperative complications between 2 groups(P>0.05).Conclusion Although PPE combined with PSP can provide good biomechanical support and biocompatibility in rhinoplasty,postoperative care,active prevention and management of complications should be strengthened.

关 键 词：鼻修复 多孔高密度聚乙烯 硅胶假体 瘢痕增生 并发症 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]