自体肋软骨鼻整形术后并发症发生情况及预防策略分析

Analysis of Complications and Preventive Strategies in Patients with Autologous Costal Cartilage Rhinoplasty

目的:探讨自体肋软骨鼻整形术后并发症发生情况及预防策略。方法:选取2020年1月-2021年12月医院收治的行自体肋软骨鼻整形术就医者152例为研究对象,比较所有就医者术前和术后6个月鼻部美学指标变化,并记录其术后并发症发生情况。结果:就医者术后6个月鼻尖突度、鼻面角高于术前,差异有统计学意义(P<0.05);术前与术后6个月鼻唇角、鼻额角比较,差异无统计学意义(P>0.05)。140例就医者表示术后效果满意,未出现并发症;12例术后出现并发症。3例(1.97%)软骨吸收,其中1例软骨吸收合并感染和1例软骨吸收合并软骨变形,均在可接受范围内,未行二次修复手术;1例软骨吸收合并感染,行抗感染、换药和红外线理疗后治愈。9例(5.92%)软骨变形,其中3例软骨变形在可接受范围内,未行二次修复;6例软骨变形显著,经二次修复校正软骨弯曲得到明显改善。结论:自体肋软骨鼻整形术后并发症发生率较低,其中软骨变形最常见,可通过选取软骨平直部分,保留髓质,对称雕刻法和交叉横切法等显著降低软骨变形发生率,术中严格轻柔精确操作及严格无菌操作可减少感染发生。

Objective To investigate the incidence of postoperative complications and preventive strategies in patients with autologous costal cartilage rhinoplasty.Methods A total of 152 patients with autologous costal cartilage rhinoplasty who were admitted to the hospital from January 2020 to December 2021 were selected.The changes of nasal aesthetic indexes of all patients before and 6 months after surgery were compared,and the postoperative complications were recorded.Results The nasal tip convexity and nasofacial angle were higher than those before operation 6 months after operation,the differences were statistically significant(P<0.05).There were no significant difference in the nasolabial angle and nasofrontal angle between preoperative and postoperative 6 months(P>0.05).140 patients reported satisfactory postoperative results without complications.Postoperative complications occurred in 12 cases.Among them,cartilage was absorbed in 3 cases,accounting for 1.97%.One case of cartilage resorption combined with infection and 1 case of cartilage resorption combined with cartilage deformation were all within the acceptable range,and no secondary repair surgery was performed.One case of cartilage absorption complicated with infection was cured after oral antibiotics,dressing change and infrared physiotherapy.Nine cases of cartilage deformation,accounting for 5.92%.Among them,3 cases of cartilage deformation were within the acceptable range,and no secondary repair was performed.Cartilage deformation was significant in 6 cases,and the curvature of cartilage was significantly improved after secondary repair.Conclusion The incidence of complication rates after autologous costal cartilage rhinoplasty is low,among which cartilage deformation is the most common.The incidence of cartilage deformation can be significantly reduced by selecting the straight part of the cartilage,preserving the medulla,symmetrical carving and cross-sectioning,etc.Strictly gentle and precise operation and strict aseptic operation can reduce the occurrence of infection.