闭合入路与开放入路鼻整形术安全性与有效性的临床比较

Clinical comparison of safety and effectiveness of rhinoplasty through closed approach and open approach

目的比较闭合入路与开放入路鼻整形术的安全性与有效性。方法回顾性分析90例行鼻整形术患者的临床资料。根据其手术方法分为观察组(45例)和对照组(45例)。观察组采用闭合入路保留鼻部重要解剖结构的鼻整形手术方式,对照组采用传统开放入路经鼻小柱切口的手术方式。对比两组手术时长、术中失血量、术后引流量及并发症(切口延迟愈合、鼻小柱血运障碍、支架部分吸收)情况。结果本组90例患者获随访6~12个月。对照组手术时长较观察组短(P<0.05);对照组术中出血量及术后引流量均多于观察组(P<0.05);观察组并发症发生率(4.4%)低于对照组(17.8%),P<0.05;观察组术后6、12个月的美观满意度评分均高于对照组(P<0.05)。结论经闭合入路保留鼻部重要解剖结构的鼻整形术是基于解剖学研究基础的一种较新的手术方法,与经典的传统开放入路手术术式相比,术中及术后并发症发生率均明显降低,且作为美容手术因其鼻部外观无切口,患者的满意度明显升高,是一种值得推广的鼻整形术。

Objective To compare the safety and effectiveness ofrhinoplasty through closed approach and open approach. Methods The clinical data of 90 patients underwent rhinoplasty through closed approach or open approach were retrospectively analyzed. All patients were divided into the observation group(45 cases) and the control group(45 cases). The rhinoplasty through closed approach was performed in the observation group, while the operation of traditional open approach with transcolumellar incision was performed in the control group. The operation duration, intraoperative blood loss, postoperative drainage and the occurrence of postoperative complications(delayed healing of incision, blood supply disorder of nasal columella and partial absorption of framework) between two groups were compared. Results All 90 patients were followed-up from 6 to 12 months. The operation duration in the control group was shorter than that in the observation group(P<0.05). The intraoperative blood loss and postoperative drainage in the control group were more than that in the observation group(P<0.05). The incidence rate of complications in the observation group(4.4%) was lower than that in the control group(17.8%).At 6 and 12 months after operation, the scores of aesthetic satisfaction in the observation group were higher than that in the control group(P<0.05). Conclusion The preservation rhinoplasty through closed approach is a novel surgical procedure based on the latest anatomical research. Compared to the traditional open approach, the incidence of complications during and after operation has been obviously decreased. There is no incision in the appearance of nose. Patients’ satisfaction is high. It should be considered for popularization.