鼻骨骨折合并鼻中隔骨折的临床特点及分类  

Clinical characteristics and classification of nasal fracture combined with septal fractures

作　　者：余庆雄 李辰龙 林奈尔 何爱娟 谢友舟 叶信海 张天宇 傅窈窈 YU Qingxiong;LI Chenlong;LIN Naier;HE Aijuan;XIE Youzhou;YE Xinhai;ZHANG Tianyu;FU Yaoyao(Department of Facial Plastic and Reconstructive Surgery,Eye&ENT Hospital,Fudan University,Shanghai 200031,China;Department of Radiology,Eye&ENT Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼耳鼻整形外科,上海200031 [2]复旦大学附属眼耳鼻喉科医院放射科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2024年第3期177-181,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的总结鼻骨骨折中合并鼻中隔骨折的临床特点,并对鼻中隔骨折进行分型和疗效观察。方法回顾分析91例在我科行鼻骨骨折手术复位患者的临床及CT影像学资料。根据是否伴鼻中隔骨折,将鼻骨骨折分为单纯鼻骨骨折组(A组)和鼻骨骨折合并鼻中隔骨折组(B组),比较2组患者的性别构成、年龄、鼻骨骨折分级差异,分析鼻中隔骨折的发生部位以及治疗效果。结果91例鼻骨骨折患者中,36例伴鼻中隔骨折(39.6%),2组在性别构成上差异无统计学意义,但B组患者的年龄及骨折分级显著高于A组。61.1%(22/36)的鼻中隔骨折发生于鼻骨下骨性鼻中隔前端(TypeⅠ),30.6%(11/36)发生于骨性鼻中隔前端和中段(TypeⅡ),8.3%(3/36)贯穿骨性鼻中隔和软骨中隔(TypeⅢ)。鼻中隔骨折经闭合复位和术后填塞可获得良好对位愈合。结论成年、严重的鼻骨骨折更易伴鼻中隔骨折,且好发于骨性鼻中隔前端,通过闭合复位可获得良好治疗效果。Objective To summarize the clinical characteristics of nasal fracture combined with septal fracture and to analyze the classification and the therapeutic effect of septal fracture.Methods The clinical data and CT images of 91 patients who had undergone surgical reduction of nasal fracture in our department were analyzed retrospectively.All patients were divided into the group of simple nasal fracture(Group A)and the group of nasal fracture combined with septal fracture(Group B),and the differences in gender composition,age,and grading of nasal fracture between the two groups were compared.The occurrence site and the curative effect of nasal septal fracture were analyzed statistically.Results Among the 91 patients with nasal fractures,36 had concomitant septal fractures(39.6%).There was no significant difference between Group A and Group B in terms of gender composition,while both the age of the patients and fracture grading were significantly higher in Group B than those in Group A.There was 61.1%(22/36)of the septal fractures which occurred in the anterior end of the infranasal bony septum(TypeⅠ),30.6%(11/36)in the anterior and middle bony septum(TypeⅡ),and 8.3%(3/36)through the bony septum and cartilaginous septum(TypeⅢ).Patients with septal fractures all obtained satisfied outcomes with closed reduction and postoperative compression.Conclusions Adult and severe nasal fractures are more likely to be accompanied by septal fractures.The nasal septal fractures is more likely to occur at the anterior end of the bony septum,and good clinical results can be achieved by closed reduction.

关 键 词：鼻骨骨折 鼻中隔骨折 骨折分型 闭合复位 鼻中隔成形 

分 类 号：R764[医药卫生—耳鼻咽喉科]