固体硅胶与膨体聚四氟乙烯鼻整形术后并发感染对比及危险因素分析  

Contrast and risk factor analysis of infection after solid silica gel and expanded polytetrafluoroethylene rhinoplasty

作　　者：韩仁环 魏林立 王汉峰 HAN Renhuan;WEI Linli;WANG Hanfeng(Deparement of Plastics and Burns,Xi'an International Medical Center Hospital,Xi'an 710100,China)

机构地区：[1]西安国际医学中心医院烧伤整形科,陕西西安710100

出　　处：《中国美容整形外科杂志》2023年第1期34-37,41,共5页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 对比固体硅胶与膨体聚四氟乙烯鼻整形术后并发感染情况并分析其危险因素。方法 回顾性分析自2020年6月至2022年6月,于西安国际医学中心医院烧伤整形科行鼻整形术95例患者的临床资料,根据术中置入材料不同分为观察组51例(膨体聚四氟乙烯)和对照组44例(固体硅胶)。对比两组一般资料,术后并发感染率,术前、术后6个月及2年的鼻部塑形指标。采用多因素logistic回归分析探讨鼻整形术后并发感染的危险因素。结果 观察组9例(17.64%)术后并发感染,对照组为5例(11.36%),两组差异无统计学意义(P>0.05)。与术前相比,两组术后6个月、2年的鼻根高、鼻面角、鼻尖角均下降(P<0.05);观察组鼻额角下降(P<0.05),对照组鼻额角差异无统计学意义(P>0.05)。术后2年,观察组鼻根高、鼻面角、鼻尖角高于对照组(P<0.05)。多因素logistics回归分析显示,鼻部综合整形术式、鼻部皮脂分泌旺盛、鼻翼软骨处理、术后鼻部术区毛囊炎、术后双侧鼻前庭黏膜破溃为鼻整形术后并发感染的危险因素(P<0.05)。结论 与固体硅胶相比,膨体聚四氟乙烯鼻整形不增加感染率,且远期疗效更好。鼻部综合整形术式、鼻部皮脂分泌旺盛、鼻翼软骨处理、术后鼻部术区毛囊炎、术后双侧鼻前庭黏膜破溃为鼻整形术后并发感染的危险因素。Objective To explore and analyze the comparison and risk factors of infection after rhinoplasty between solid silica gel and expanded polytetrafluoroethylene(e-PTFE) rhinoplasty. Methods A retrospective analysis was performed on 95 patients who underwent rhinoplasty from June 2020 to June 2022. According to the different implanted materials, they were divided into the control group of 44 cases and the observation group of 51 cases. The control group was implanted with solid silicone soft tissue, and the observation group was implanted with e-PTFE prosthesis. The general data, the postoperative infection rate, and the nasal shaping indexes at 6 months and2 years after the operation of the control group and the observation group were compared. Multivariate logistic regression analysis was used to investigate the risk factors of postoperative infection after rhinoplasty. Results Nine cases(17.64%) of postoperative complications in the observation group were more than 5 cases(11.36%) in the control group, but there was no significant difference in the infection rate between the two groups(P>0.05). The nasal root height, nasal facial angle and nasal tip angle were decreased at 6 months and 2 years after the operation in two groups(P<0.05), and the nose frontal angle in the observation group was decreased(P<0.05), but the nose frontal angle was no significant difference in the control group(P>0.05). Two years after the operation, the nasal root height, nasal facial angle and nasal tip angle in the observation group were higher than those in the control group(P<0.05). Multivariate logistic regression analysis showed that comprehensive nasal plastic surgery, strong nasal sebum secretion, nasal alar cartilage treatment, postoperative folliculitis in the nasal surgical area, and postoperative bilateral nasal vestibular mucosal ulceration were the risk factors for postoperative infection after implanted rhinoplasty(P<0.05). Conclusion Compared with solid silica gel, e-PTFE rhinoplasty does not increase the infection rate, a

关 键 词：鼻整形术 膨体聚四氟乙烯 固体硅胶 感染 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]