鼻中隔穿孔修补术围手术期的临床观察

Observation of Curative Effect of Selection of Transplant Tissue in Repairing of Nasal Sepal Perforation

目的观察修补鼻中隔穿孔移植组织围手术期的生长愈合情况。方法对13例鼻中隔穿孔长径5～26mm,选用黏膜(中鼻甲黏膜、下鼻甲黏膜、口腔颊黏膜)或阔筋膜,以及自体鼻中隔骨板为移植材料。用两层移植黏膜或筋膜中间夹中隔骨板,而后将这三层组织嵌插于穿孔的鼻中隔黏膜间修补穿孔。结果穿孔长径在5～14mm大小之间用黏膜夹中隔骨板修补(下鼻甲黏膜修补2例;中鼻甲黏膜修补2例;口腔颊黏膜修补5例)。均在20天内愈合,其中有1例因移植物偏小,前端有小裂缝3mm,后进行二次修复。穿孔长径在15～26mm用筋膜包绕骨板修补4例,20～36d愈合。结论鼻中隔骨板包绕筋膜(或黏膜)嵌插修补法形成稳定移植环境,筋膜被生长的中隔黏骨膜覆盖,3种移植黏膜均保持原组织的特点,以颊黏膜组织最佳。

Objective To observe the healing of the transplanted tissue in repairing of nasal septal perforation round the surgcal operation.Methods A total of 13 cases of nasal septat perforation round the path grow from 5~26mm,fascia or mucose and lamina mediana were chosen as transplant tissues.The lamina mediana 1S inserted in mucose or fascia then three layerS transplanted tissues were inserted into lamina perpendicular for repairing the perforation of nasal septal.Results The size of perforation at 5~14mm were repaired with the mucosa cp the lamina mediana.（2 cases of inferior tubinate mucose,2 cases ot middle turbinate mucose,5 cases of cheek mucose）and all of them were healed in 20 days：One case was repaired for the second time,because the transplanted tissue was small and the anterior appeared 3mm crack,4 cases with the perforation at 15～26mm were repaired with the lamina mediana wraped by fascia and healed from 20 days to 26 days.Conclusion The lamina mediana wraped by fascia to repair the perforation can establish tile stable transplantation environment,the fascia is covered with the growing mucosa,three kinds of the mucosa all keep the traits of original tissue.