根据鼻部美学亚单位概念比较鼻部不同部位缺损修复时皮瓣的应用方法和效果差异  

Comparison of the application methods and effects of skin flaps in the repair of defects in different parts of the nose according to the concept of aesthetic nosesubunits

作　　者：华骋 张维娜[1] 吕乐乐 任纪祯[1] 刘肃 苗嫄昕[1] 隋朝阳 毛凯平[4] Hua Cheng;Zhang Weina;Lyu Lele;Ren Jizhen;Liu Su;Miao Yuanxin;Sui Zhaoyang;Mao Kaiping(Aesthetic Plastic Surgery Department,Affiliated Hospital of Qingdao University,Qingdao 266000,China;Beckman Laser Institute Korea,Dankook University College of Medicine,Cheonan 31116,Republic of Korea;Medical Aesthetic Department,Qingdao New Century Women′s and Children′s Hospital,Qingdao 266000,China;Department of Thoracic Surgery,Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院美容整形外科,青岛266000 [2]韩国贝克曼激光研究所檀国大学医学院,大韩民国天安市31116 [3]青岛新世纪妇儿医院医学美容科,青岛266000 [4]青岛大学附属医院胸外科,青岛266000

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第4期339-344,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的分析鼻部不同美学亚单位中小面积缺损时局部皮瓣的应用方法和效果差异,以期为临床工作提供参考。方法回顾性分析2021年7月1日至2022年1月30日于青岛大学附属医院美容整形外科行手术治疗的外鼻肿物及瘢痕患者59例,其中女性27例,男性32例,年龄15~69岁。采用李克特量表,从术区质地、平整度、瘢痕隐蔽程度3个方面对鼻部软组织缺损的局部皮瓣的修复术式、修复效果进行评估和总结。使用Graphpad Prism 5.0软件进行数据统计和分析。结果使用局部皮瓣修复鼻部中小面积缺损能达到较满意的效果。对不同鼻部亚单位缺损的患者,在皮肤平整度和瘢痕隐蔽程度方面,患者对鼻背区和鼻侧区的满意度均比鼻翼区和鼻尖区更高(F=6.40,P=0.001;F=10.57,P<0.001)。对不同皮瓣修复方式的患者,在皮肤平整度方面,患者对Z成形术和改良菱形皮瓣的满意度比其他几种皮瓣修复方式更高(F=4.38,P=0.002);在瘢痕隐蔽程度方面,患者对改良菱形皮瓣的满意度最高(F=2.57,P=0.038)。结论在鼻部中小面积的缺损中,使用多种局部皮瓣修复均能达到良好的美容效果和功能恢复,术者应根据不同鼻部美学亚单位的特点选择合适的皮瓣修复方式。Objective To analyze the difference of application methods and effects of local flap in small and medium-sized defects of different aesthetic subunits of nose,in order to provide reference for clinical work.Methods A retrospective analysis was made on 59 patients with external nasal masses and scars who underwent surgical treatment in the Department of Aesthetic Plastic Surgery of the Affiliated Hospital of Qingdao University from July 1,2021 to January 30,2022,including 27 females and 32 males,aged 15 to 69 years.Using Likert scale,the repair methods and effects of local flap for nasal soft tissue defects were evaluated and summarized from three aspects of texture,flatness and scar concealment.GraphPad Prism 5.0 software was used for data statistics and analysis.Results The use of skin flaps to repair small and medium-sized areas of the nose could achieve satisfactory results.For patients with different subunits,in terms of skin flatness and scar concealment degree in the operation area,patients′satisfaction with the dorsal and lateral nasal areas was higher than that of the alar and tip areas,respectively(F=6.40,P=0.001;F=10.57,P<0.001).For patients with different skin flap repair methods,the satisfaction of patients with Z-plasty and Dufourmentel skin flap was higher than that of other skin flap repair methods(F=4.38,P=0.002),and the satisfaction of patients with Dufourmentel skin flap was the highest in the degree of scar concealment(F=2.57,P=0.038).Conclusions In the small and medium-sized defects of the nose,the use of multiple local flaps can achieve good cosmetic effects and functional recovery.The operator should select the appropriate flap repair method according to the characteristics of different aesthetic subunits of the nose.

关 键 词：鼻 修复 美学亚单位 皮瓣 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]