隆鼻术后再修复患者的临床特征和重修危险因素分析  

Clinical Characteristics of Patients with Post-Rhinoplasty Revision Surgery and Analysis of Risk Factors for Re-Revision

作　　者：周璐珩 詹林龙 王旭明 谢锦清 ZHOU Luheng;ZHAN Linlong;WANG Xuming;XIE Jinqing(Department of Plastic Surgery,Chongqing Vcharm Plastic Surgery Hospital,Chongqing 400000,China)

机构地区：[1]重庆当代整形外科医院整形外科,重庆400000

出　　处：《中国美容医学》2023年第8期14-18,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨隆鼻术后患者进行修复的原因及修复难度特点,并评估患者需要再次行修复手术的危险因素。方法:本研究回顾性纳入236例行隆鼻术后修复的患者,所有入组患者的平均年龄为(29.23±4.31)岁。根据手术前后的照片和病历分析患者修复的原因,并根据PGS分级术前对患者的修复难度进行分析对比。结果:术前已经进行鼻部修复手术的患者倾向于对手术的结果产生怀疑(P<0.001)。鼻部修复的原因相较于初次隆鼻的原因来说,功能因素的比重由33.47%增加到41.95%,其中呼吸不畅是最主要原因(21.61%);而在美容因素中,鼻尖的问题(28.39%)是修复的最主要原因。术前的手术难度分析也表明,先前已经进行鼻部修复手术后,患者此次PGS分级也更高(P<0.001)。对手术结果期待为C或D级(P=0.012)以及PGS分级(P=0.022,0.031和0.041)是患者术后需要再次行修复术的独立危险因素。结论:随着修复次数的增加,手术难度不断增加,术后需要再次修复的可能性也在增加。Objective To investigate the causes and difficulties of revision surgery after rhinoplasty,and to assess the risk factors for patients requiring a re-revision surgery.Methods This study retrospectively enrolled 236 patients who underwent post-operative revision surgery.The causes of revision surgery were determined based on pre-operative and post-operative photographs and medical records.The difficulty of revision surgery was evaluated according to the PGS stage system preoperatively.Results The mean age of all patients enrolled was 29.23±4.31 years.Patients who had already undergone preoperative nasal repair surgery tended to be skeptical about the outcome of the procedure(P<0.001).The proportion of functional causes increased from 33.47%to 41.95%compared to the initial rhinoplasty,with apnea being the most common cause(21.61%).Among the cosmetic causes,problems with the nasal tip(28.39%)were the most common causes for revision surgery.Preoperative analysis of surgical difficulty also showed that patients who had already undergone preoperative nasal repair surgery had the higher the PGS stages(P<0.001).Expectation on outcome grade C or D(P=0.012)and PGS grading(P=0.022,0.031,and 0.041)were independent risk factors for the need for a re-revision surgery.Conclusion The difficulty of revision surgery increases with the increase of the number of revision surgery,while the likelihood of requiring another re-revision postoperatively also increases.

关 键 词：鼻整形术 二次修复 PGS分级 手术期待 危险因素 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]