复合面部轮廓整形术后并发症的防治

The preservation and therapy of postoperative complications after comprehensive correction of facial skeletal contouring

目的 探讨复合面部轮廓整形术后并发症的预防和治疗.方法 回顾性分析自2007年11月至2010年3月,同时接受2项（含2项）以上面部轮廓改形术的178例患者术后出现的各种并发症及其处理结果.手术方式包括下颌骨截骨、颧骨颧弓复合体截骨、颏部截骨、鼻部截骨.术后出现低氧血症者26例,低钾血症者11例,高血压者18例,心律失常者21例,呼吸道阻塞者6例,下颌部出血者2例,躁动者17例,恶心呕吐者65例.结果 经及时的对症处理后,未发生呼吸衰竭、失血性休克等严重并发症.术后随访178例患者6～12个月,患者对面部外形满意,且未再出现其他并发症.结论 复合面部轮廓整形术后的并发症较复杂,严重者可能危及生命.因此,必须根据发生的原因,采取有效的预防措施和积极的治疗方法,从而降低并发症的发生概率,提高手术的安全性.

Objective To explore the preservation and therapy of postoperative complications after com- prehensive correction of facial skeletal contouring. Methods Retrospective analysis was performed on postop- erative complications after comprehensive correction with two or more facial skeletal contouring operations in 178 patients from November 2007 to March 2010. The surgical procedure included mandibular osteotomy, complex zygoma zygomatic arch osteotomy, chin osteotomy and nasal osteotomy. Postoperative complications happened in 26 cases with hypoxemia, 11 cases with hypokalemia, 18 cases with hypertension, 21 cases with arrhythmia, 6 cases with airway obstruction, 2 cases with lower jaw bleeding, 17 cases with restlessness, 65 cases with nausea and vomiting. Results After timely symptomatic treatment, non respiratory failure, hemorrhagic shock and other serious complications happened in any case. Totally 178 patients received satisfactory results after 6 to 12 months followed-up without recurrence of any other complications. Conclusion Postoperative complications after comprehensive correction of facial skeletal contouring may be multiplicitied and could bring threat to life. Therefore, we must take effective preventive measures and active treatment to reducing the probability of occur- rence of complications and improve the safety of surgery.