外耳再造耳后皮肤软组织扩张器植入后并发症现状及危险因素分析  

Analysis of the current status and risk factors of complications after implantation of external ear reconstruction skin and soft tissue expander

作　　者：周聪[1] 代文意 尚蕾 ZHOU Cong;DAI Wen-yi;SHANG Lie(Nanyang Central Hospital,Henan Province,473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《中国医疗美容》2024年第3期14-18,共5页China Medical Cosmetology

摘　　要：目的探讨外耳再造耳后皮肤软组织扩张器植入后并发症现状及危险因素,为临床干预措施的制定提供参考。方法对2020年1月至2023年3月在我院接受耳后皮肤软组织扩张器植入的151例(163耳)外耳再造患者临床资料进行回顾性分析,了解其并发症发生现状;根据耳后皮肤软组织扩张器植入后是否发生并发症,将其分为并发症组和无并发症组,并运用多因素Logistic回归分析外耳再造耳后皮肤软组织扩张器植入后并发症的危险因素。结果本研究163耳有37耳发生并发症,并发症总发生率为22.69%,其中血肿18例,占总并发症的48.65%,感染10耳,占比27.03%,切口裂开4耳,占比10.81%,扩张器外漏3耳,占比8.11%,扩张器不张1耳,占比2.70%,皮瓣坏死1耳,占比2.70%;并发症发生平均时间为扩张器植入后(6.82±1.65)天。单因素分析结果显示,并发症组和无并发症组在年龄、居住地、引流管放置方式、扩张器容量、注水速度等方面存在组间差异,具有统计学意义(P﹤0.05);多因素Logistic回归分析显示,居住在农村(OR=2.079,95%CI:1.166~3.707,P=0.013)、引流管平位放置(OR=1.898,95%CI::0.962~3.748,P=0.065)、扩张器容量﹥100ml(OR=2.092,95%CI:1.128~3.878,P=0.019)、注水速度每周≥3次(OR=1.962,95%CI:1.049~3.667,P=0.035)是耳后皮肤软组织扩张器植入后并发症发生的危险因素。结论外耳再造耳后皮肤软组织扩张器植入后并发症发生率较高,居住在农村、引流管平位放置、扩张器容量>100 ml、注水速度每周≥3次是并发症发生的危险因素,临床应根据患者实际情况选择合适的引流方式、扩张器容量,并实施科学的注射速度,以降低并发症发生率,为外耳再造提供充足皮瓣。Objective Exploring the current situation and risk factors of complications after the implantation of external ear reconstruction skin and soft tissue expanders,providing reference for the development of clinical intervention measures.Methods A retrospective analysis was conducted on the clinical data of 151 patients(163 ears)with external ear reconstruction who underwent posterior ear skin soft tissue expander implantation in our hospital from January 2020 to March 2023,in order to understand the current status of complications;According to whether there are complications after the implantation of the skin and soft tissue expander behind the ear,it is divided into a complication group and a non complication group,and multiple logistic regression analysis is used to identify the risk factors for complications after the implantation of the skin and soft tissue expander after external ear reconstruction.Results In this study,complications occurred in 37 out of 163 ears,with a total incidence rate of 22.69%.Among them,there were 18 cases of hematoma,accounting for 48.65%of the total complications,10 ears of infection,accounting for 27.03%,4 ears of incision rupture,accounting for 10.81%,3 ears of dilator leakage,accounting for 8.11%,1 ear of dilator non opening,accounting for 2.70%,and 1 ear of flap necrosis,accounting for 2.70%;The average time for complications to occur is(6.82±1.65)days after the implantation of the dilator.The results of univariate analysis showed that there were statistically significant differences between the complication group and the non complication group in terms of age,place of residence,drainage tube placement method,expander capacity,and water injection speed(P<0.05);Multivariate logistic regression analysis showed that living in rural areas(OR=2.079,95%CI:1.166~3.707,P=0.013),flat placement of drainage tubes(OR=1.898,95%CI:0.962~3.748,P=0.065),expander capacity>100ml(0R=2.092,95%CI:1.128~3.878,P=0.019),and water injection rate≥3 times per week(OR=1.962,95%CI:1.049~3.667,P=0.035)wer

关 键 词：外耳再造 耳后 皮肤软组织 扩张器 并发症 危险因素 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]