摘要
目的观察全耳廓再造二期立耳术中利用废弃的自体真皮、脂肪组织注射移植治疗半侧颜面短小畸形的效果。方法研究对象为2013年3月至2018年3月河南省人民医院57例单侧小耳畸形合并同侧轻、中度颜面短小畸形患者,根据手术方法不同分为同期治疗组(32例,女13例,男19例,年龄6~33岁,平均12.5岁)与传统治疗组(25例,女10例,男15例,年龄6~21岁,平均11.3岁)。同期治疗组在行改良Nagata法耳廓再造术二期立耳术(颅耳角成形术)的同期以自体真皮、脂肪组织注射填充治疗患侧颜面短小畸形;传统治疗组仅行改良Nagata法耳廓再造术二期立耳术。术后统计分析两组患者平均手术时间、平均住院天数、手术常见并发症发生率及术后效果满意率。应用SPSS 21.0软件进行统计学分析。结果同期治疗组平均手术时间[(282.0±3.4)min]较传统治疗组平均手术时间[(243.0±3.1)min]长,差异有统计学意义(t=9.884,P<0.05);同期治疗组平均住院天数[(9.4±0.3)d]与传统治疗组平均住院天数[(9.5±0.2)d]接近,差异无统计学意义(t=0.256,P>0.05);同期治疗组手术常见并发症发生率(12.5%,4/32)与传统治疗组(12.0%,3/25)接近,差异无统计学意义(χ^(²)=0,P>0.05);同期治疗组术后效果满意率(90.6%,29/32)高于传统治疗组(56.0%,14/25),差异有统计学意义(χ^(²)=9.081,P<0.05)。结论耳廓再造术同期利用废弃自体组织移植注射治疗半侧颜面短小畸形在提高患者满意度的同时并没有显著增加平均住院天数及常见并发症发生率;平均手术时间虽略有延长,但减少了患者总体手术次数,节约了医疗资源。
Objective To observe the treatment effect of hemifacial dysplasia by injecting transplantation of autologous dermis and fat granules in the second stage surgery for total auricle reconstruction.Methods From March 2013 to March 2018,57 patients with unilateral microtia and mild-to-moderate hemifacial dysplasia were divided into concurrent treatment group(32 cases,including 13 females and 19 males and aged 6-33 years old with an average age of 12.5 years)and traditional treatment group(25 cases,including 10 females and 15 males and aged 6-21 years old with an average age of 11.3 years)according to the different surgical methods.Modified Nagata method of auricular reconstruction was chosen,in the second stage surgery(cranial ear angle plasty),patients in concurrent treatment group received the treatment of hemifacial dysplasia with autologous dermal and fat injection transplantation at the same time;Patients in traditional treatment group only received cranial ear angle plasty.Statistical analysis of the two groups of patients was carried out for the average operation time,the average length of hospital stay,the incidence of common complications and postoperative satisfaction rate.SPSS 21.0 software was used for statistical analysis.Results The mean operation time of the concurrent treatment group(282.0±3.4)min was longer than that of the traditional treatment group(243.0±3.1)min,and the difference was statistically significant(t=9.884,P<0.05).There were no statistically significant differences in the average length of stay between the the concurrent treatment group(9.4±0.3)d and the traditional treatment group(9.5±0.2)d,t=0.256,P>0.05.There were no statistically significant differences in the incidence of common surgical complications between the concurrent treatment group(12.5%,4/32)and the traditional treatment group(12.0%,3/25),χ^(²)=0,P>0.05.Postoperative satisfaction rate of the concurrent treatment group(90.6%,29/32)was significantly higher than that of the traditional treatment group(56.0%,14/25),the difference was statistically significant(χ^(²)=9.081,P<0.05).Conclusions Auricular reconstruction with treatment of hemifacial dysplasia should not significantly increase the average length of stay and the incidence of common complications compared with auricular reconstruction alone.Although the operation time is slightly extended,the scheme of concurrent treatment can reduce the times of operations,save medical resources and increase the satisfaction rate of patients.
作者
张栋益
张璐璐
王志朋
许颖溦
刘清亮
赵尚华
康深松
Zhang Dongyi;Zhang Lulu;Wang Zhipeng;Xu Yingwei;Liu Qingliang;Zhao Shanghua;Kang Shensong(Department of Plastic Surgery,Henan Provincial People′s Hospital,People′s Hospital of Henan University,People′s Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华耳鼻咽喉头颈外科杂志》
CSCD
北大核心
2021年第6期643-647,共5页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
河南省医学科技攻关项目(201003099,201602180,201702172)
河南省科技攻关重点项目(092102310067)。
关键词
耳畸形
先天性
小耳畸形
半侧颜面短小
外科
整形
Ear deformities,congenital
Microtia
Hemifacial dysplasia
Surgery,plastic
