鼻内镜下早期手术治疗鼻骨骨折伴鼻中隔骨折31例

Early endoscopic surgery for 31 patients with nasal bone fracture and nasal septum fracture

目的探讨早期行鼻内镜下手术治疗鼻骨骨折伴鼻中隔骨折的疗效和实用性。方法选取2014年1月至2017年12月合肥市第三人民医院收治的31例外伤性鼻骨骨折伴鼻中隔骨折的病人作为治疗组,行早期鼻内镜下鼻中隔成形术+骨折闭合性复位术;选取同期该院31例不愿意行鼻内镜手术的外伤性鼻骨骨折伴鼻中隔骨折病人作为对照组,行骨折闭合性复位术。对病人术前及术后鼻腔通气及鼻腔外观进行视觉模拟评分(VAS),并观察两组病人术后鼻中隔穿孔、血肿、鼻腔粘连等并发症的发生情况。结果治疗组术后鼻腔外观(2.35±0.66)分及鼻腔通气(2.26±0.51)分VAS评分均优于对照组(3.06±1.24)分、(3.19±1.90)分,均差异有统计学意义(t=2.819、2.640,P=0.007、0.011)。治疗组与对照组比较,手术方法不增加手术风险。结论鼻骨骨折伴鼻中隔骨折的病人采取鼻内镜下鼻中隔成形术+骨折闭合性复位术治疗效果优于单纯骨折复位术,可同时解决鼻中隔骨折和鼻骨复位,减少手术危险性,避免了鼻中隔的二次手术,具有可行性、实用性、经济性。

Objective To investigate the curative effect and practicability of early endoscopic surgery in the treatment of nasal bone fracture combined with nasal septum fracture.Methods Thirty-one patients with traumatic nasal bone fracture and nasal septum fracture admitted to The Third People’s Hospital of Hefei City from January 2014 to December 2017 in the treatment group were treated with early nasal septoplasty and closed reduction of fracture,while 31 patients with traumatic nasal bone fracture and nasal septum fracture in the control group were treated with closed reduction.Visual analogue scale(VAS) was used to evaluate the nasal ventilation and nasal appearance of the patients before and after operation,and the incidence of postoperative complications such as nasal septum perforation,hematoma and nasal adhesion was observed in the two groups.Results The VAS score of nasal shape(2.35±0.66) and nasal ventilation(2.26±0.51) in the treatment group was better than that in the control group(3.06±1.24) and(3.19±1.90),with statistically significant differences(t=2.819,2.640,P=0.007,0.011).Compared with the control group,the operative method did not increase the risk of operation.Conclusion In patients with traumatic nasal bone fracture and nasal septum fracture,treatment with nasal septoplasty and closed reduction of fracture is better than simple closed reduction of fracture.It can solve the problem of nasal septum fracture and nasal bone reduction at the same time and reduce the risk of operation and avoid 2 nd nasal septum surgery,which is feasible,practical and economical.