高频超声在鼻骨骨折的诊断及治疗中的应用价值

Application value of ultrasonography in diagnosis and treatment of nasal bone fracture

目的探讨高频超声在鼻骨骨折的诊断及治疗中的应用价值。方法选取2019年1月—2020年12月就诊于郑州大学附属郑州中心医院104例可疑鼻骨骨折患者,行鼻骨CT、高频超声(US)检查,以CT为标准,分析US对鼻骨骨折的诊断效能;确诊为鼻骨骨折且需手术的患者70例,采取随机数字表法分为两组,对照组35例采用常规复位,试验组35例采用超声引导下复位,应用鼻外形视觉模拟量表(VAS)、鼻整形结果评估表(ROE)评估术前及术后3月鼻通气及鼻外形情况,采用SPSS 21.0软件进行统计学分析。结果以CT为标准,US的敏感度97.9%、特异度80%、阳性预测值97.9%、阴性预测值80%。试验组复位次数低于对照组,差异具有统计学意义(P<0.05);和手术前相比,两组患者术后鼻外形VAS评分、ROE评分均提高,试验组提高更显著,两组指标对比,差异有统计学意义(P<0.05)。结论高频超声可考虑作为诊断鼻骨骨折的另一选择,超声引导下施行鼻骨骨折复位,可使鼻骨骨折复位可视化,患者主观满意度提高。

Objective To explore the value of ultrasonography(US)in the diagnosis and treatment of nasal-bone frac⁃ture.Methods A total of 104 patients with suspicious nasal bone fractures in our hospital from January 2019 to Decem⁃ber 2020 were selected for nasal bone CT and high-frequency ultrasound(US)examinations.CT was used as the standard to analyze the diagnostic efficacy of US for nasal bone fractures;Seventy patients who needed surgery for nasal bone fractures were divided into two groups by random number table method.35 cases in the control group used conven⁃tional reduction,and 35 cases in the experimental group used ultrasound-guided reduction.The plastic surgery result evaluation form(ROE)was used to evaluate the nasal ventilation and nasal shape before and 3 months after the opera⁃tion,and the SPSS 21.0 software was used for statistical data analysis.Results For the diagnosis of nasal bone frac⁃ture,using CT as the standard,the sensitivity of US was 97.9%,the specificity was 80%,the positive predictive value was 97.9%,and the negative predictive value was 80%.The number of reduction operations for nasal bone fractures under ultrasound guidance was less than in the conventional group,and the difference was statistically significant(P<0.05);Compared with preoperatively,the postoperative VAS score and ROE score of the nasal shape of the experi⁃mental group and the control group were improved.The nasal shape VAS score and ROE score of the experimental group increased more significantly than the control group.The comparison of the two groups of indicators showed a statistically significant difference.(P<0.05).Conclusion Ultrasonography can be used as another choice for the diagnosis of na⁃sal bone fractures.The ultrasound-guided reduction of nasal bone fractures can visualize the reduction of nasal bone fractures and improve the subjective satisfaction of patients.