高频超声在儿童鼻骨骨折闭合复位术的应用研究

doi:10.6040/j.issn.1673-3770.0.2023.188

摘要/Abstract

摘要： 目的探讨高频超声在儿童鼻骨骨折闭合复位术中的应用价值。方法回顾分析72 例儿童鼻骨骨折患儿,所有患儿术前均行鼻骨 CT 扫描,随机分为实验组和对照组,实验组在高频超声引导下行鼻骨骨折复位手术,对照组采取传统的复位器盲复位,观察患儿手术时间、住院时间、术后鼻腔通气、鼻部疼痛及鼻外观情况。结果实验组36例患儿均在全麻下高频超声引导下行鼻骨骨折闭合复位手术,术中对位准确,填塞物固定稳妥,手术及住院时间短,术后随访3个月,患儿鼻腔通气、鼻部疼痛、鼻外观均优于对照组。所有患儿均未出现严重并发症。结论在高频超声引导下行儿童鼻骨骨折复位术,可以全程监测骨折碎片及复位器、填塞物的位置情况,复位准确,手术及住院时间均较短,减少反复行 CT 检查放射线对儿童生长发育的影响,可以作为治疗儿童鼻骨骨折的手术方案之一。

关键词: 高频超声, 儿童, 鼻骨骨折, 闭合复位, 全程监测

Abstract: Objective To evaluate the application value of high-frequency ultrasound in closed reduction of nasal bone fracture in children. Methods This study included 72 children with nasal bone fractures. CT scan imaging of the nasal bone was performed in children before surgery. Children were randomly divided into experimental and control groups. Children from the experimental group were treated with high frequency ultrasound-guided reduction of nasal bone fracture, whereas those from the control group were treated with the traditional reduction method. The operation and hospitalization times together with postoperative nasal ventilation, nasal pain, and nasal appearance were analyzed. Results The 36 children from the experimental group were treated with closed reduction of nasal bone fracture by high frequency ultrasound; during the operation, the alignment was accurate and the filling was stable. Moreover, surgical and hospitalization times were shorter than for those in the control group. After a 3-month follow-up, nasal ventilation, nasal pain, and nasal appearance evaluation scores were better in children from the experimental group than in those from the control group. None of the children suffered from severe postoperative complications. Conclusion High frequency ultrasound in closed reduction of children nasal fracture monitors the position of fracture fragments, reduction instruments, and packs, leading to accurate reductions and shorter surgical and hospitalization times and reducing the impact of repeated CT radiation on children growth and development. Therefore, it is a suitable surgical option for the treatment of a child's nasal fracture.

Key words: High frequency ultrasound, Children, Nasal bone fracture, Closed reduction, Full monitoring

中图分类号:

R765.8

杨娜,柳荫,郭宝,纪尧峰,成晨,张琛,董丽娜. 高频超声在儿童鼻骨骨折闭合复位术的应用研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 41-45.

YANG Na, LIU Yin, GUO Bao, JI Yaofeng, CHENG Chen, ZHANG Chen, DONG Lina. High frequency ultrasound in closed reduction of nasal fracture in children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 41-45.

参考文献

[1] Pham TT, Lester E, Grigorian A, et al. National analysis of risk factors for nasal fractures and associated injuries in trauma[J]. Craniomaxillofac Trauma Reconstr, 2019, 12(3): 221-227. doi:10.1055/s-0039-1677724
[2] 张柳青, 孙艺渊, 王珮华, 等. 2881例鼻骨骨折患者流行病学分析[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(3): 239-243. doi: 10.13201/j.issn.2096-7993.2020.03.013 ZHANG Liuqing, SUN Yiyan, WANG Peihua, et al. Epidemiological analysis of 2 881 patients with nasal bone fracture[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(3): 239-243. doi: 10.13201/j.issn.2096-7993.2020.03.013
[3] Sindi A, Abaalkhail Y, Malas M, et al. Patients with nasal fracture[J]. J Craniofac Surg, 2020, 31(3): 275-277. doi:10.1097/SCS.0000000000006269
[4] 陈凯, 王君, 唐玥玓. 鼻畸形矫正同期鼻中隔偏曲矫正术治疗严重外伤性鼻畸形一例[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 121-124. doi:10.6040/j.issn.1673-3770.0.2019.381 CHEN Kai, WANG Jun, TANG Yuedi. Nasal septum-nasal deformity surgery for correction of severe traumatic nasal deformity: a case report[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1):121-124. doi:10.6040/j.issn.1673-3770.0.2019.381
[5] 赵宇, 朱丽, 马芙蓉. 外鼻骨折分型及骨折部位对鼻中隔影响的CT分析[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(8): 527-530. doi: 10.13201/j.issn.1001-1781.2014.08.006 ZHAN Yu, ZHU Li, MA Furong. CT analysis of classification of external nasal fracture and the influence of fractured position to nasal septum[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014,28(8): 527-530. doi: 10.13201/j.issn.1001-1781.2014.08.006
[6] 刘阳云, 李正贤, 江文, 等. VAS评分对鼻咽癌放疗后慢性鼻-鼻窦炎治疗方案选择的价值[J]. 山东大学耳鼻喉眼学报, 2013, 27(4): 66-69. doi: 10.6040/j.issn.1673-3770.0.2013.146 LIU Yangyun, LI Zhengxian, JIANG Wen, et al. Visual analogue score on treatment choice for nasopharyngeal carcinoma patients with post-radiotherapy chronic rhino-sinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2013, 27(4): 66-69. doi: 10.6040/j.issn.1673-3770.0.2013.146
[7] 刘字, 胡大山. 运用主客观量化表评估慢性鼻-鼻窦炎手术疗效分析[J]. 中国中西医结合耳鼻咽喉科杂志, 2014, 22(2): 98-101. doi: 10.3969/j.issn.1007-4856.2014.02.006 LIU Zi, HU Dashan. Application of subjective and objective quantitative analysis operation curative effect of chronic rhinosinusitis assessment[J]. Chinese Journal of Otorhinolaryngology in Integrative Medicine, 2014, 22(2): 98-101. doi: 10.3969/j.issn.1007-4856.2014.02.006
[8] 武勇进, 王鹏, 韩晓东, 等. 鼻骨CT三维成像技术辅助鼻骨骨折的诊断研究[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(5): 452-455. doi: 10.13201/j.issn.2096-7993.2020.05.016 WU Yongjin, WANG Peng, HAN Xiaodong, et al. Three-dimension CT assisted treatment of nasal fracture[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(5): 452-455. doi: 10.13201/j.issn.2096-7993.2020.05.016
[9] 朱丽. 近期鼻骨与鼻中隔复合外伤鼻内镜下成形术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1)7-9. doi: 10.6040/j.issn.1673-3770.1.2017.045 ZHU Li. Reconstruction of first-stage nasal bone fractures with nasal septum deviation using endoscopic guidance[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(1)7-9. doi: 10.6040/j.issn.1673-3770.1.2017.045
[10] 侯俊杰, 田中隆太郎, 森田裕紀, 等. 超声检测技术在鼻骨骨折复位术中的应用[J]. 中国美容整形外科杂志, 2020, 31(9): 535-537. doi: 10.3969/j.issn.1673-7040.2020.09.008 HOU Junjie, TIAN Zhonglongtailang, SEN Tianyuji, et al. Application of ultrasound detection technique in the reduction of nasal bone fractures[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2020, 31(9): 535-537. doi: 10.3969/j.issn.1673-7040.2020.09.008
[11] 马莉, 沈素红. 超声全程动态监测下鼻骨骨折闭合性复位的可视化研究[J]. 医学影像学杂志, 2021, 31(5): 744-749 MA Li, SHEN Suhong. Visualization of closed reduction of fresh nasal bone fractures under whole-course dynamic ultrasound monitoring[J]. Journal of Medical Imaging, 2021, 31(5): 744-749
[12] 张红, 任燎原, 严婷, 等. 超声与CT诊断鼻骨骨折的应用价值比较[J]. 临床超声医学杂志, 2019, 21(7)547-549 ZHANG Hong, REN Liaoyuan, YAN Ting, et al. Application value of ultrasound and CT scanning in nasal bone fracture diagnosis[J]. Journal of Clinical Ultrasound in Medicine, 2019, 21(7): 547-549
[13] 沈素红, 马莉, 付卓, 等. 高频超声诊断鼻骨骨折及引导闭合复位的临床价值[J]. 中华超声影像学杂志, 2018, 27(10): 914-915. doi:10.3760/cma.j.issn.1004-4477.2018.10.020
[14] Astaraki P, Baghchi B, Ahadi M. Diagnosis of acute nasal fractures using ultrasound and CT scan[J]. Ann Med Surg, 2022, 78: 103860. doi:10.1016/j.amsu.2022.103860
[15] 杨普查, 苗凤玲, 赵新宇. 鼻骨骨折的高频超声研究[J]. 生物医学工程与临床, 2017, 21(5): 495-498. doi:10.13339/j.cnki.sglc.20170906.008 YANG Pucha, MIAO Fengling, ZHAO Xinyu. Study on nasal bone fracture by high-frequency ultrasound[J]. China Industrial Economics, 2017, 21(5): 495-498. doi:10.13339/j.cnki.sglc.20170906.008
[16] Liu Clive, Legocki AlexT, Mader Nicholas S, et al. Nasal fractures in children and adolescents: mechanisms of injury and efficacy of closed reduction[J]. International Journal of Pediatric Otorhinolaryngology, 2015, 79(12): 2238-2242. doi: 10.1016/j.ijporl.2015.10.011
[17] 浦诗磊, 徐宏鸣, 李晓艳. 儿童鼻骨骨折的临床特征分析[J].中国眼耳鼻喉科杂志, 2023, 23(1):60-63, 72. doi: 10.14166/j.issn.1671-2420.2023.01.012 PU Shilei, XU Hongming, LI Xiaoyan. Clinical characteristics of nasal bone fracture in children[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2023, 23(1):60-63, 72. doi: 10.14166/j.issn.1671-2420.2023.01.012
[18] 危高生, 周颖, 李育广, 等. 高频超声联合鼻内镜引导下外伤性鼻骨骨折伴鼻中隔骨折同期手术治疗的疗效分析[J]. 中国实用医药, 2019, 14(33)26-28. doi: 10.14163/j.cnki.11-5547/r.2019.33.011 WEI Gaosheng, ZHOU Ying, LI Yuguang, et al. Therapeutic effect of high-frequency ultrasonography combined with simultaneous surgery on endoscopic guided traumatic nasal bone fracture with nasal septal fracture[J]. China Practical Medical, 2019, 14(33)26-28. doi: 10.14163/j.cnki.11-5547/r.2019.33.011

相关文章 15

[1]	陈丹萍,何子键,虞幼军,周晓娓. 儿童突发性聋10年住院病例的疗效及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 16-22.
[2]	姚婷婷,张德伦,李兰. 婴儿下咽部胃黏膜异位症引发咽喉反流症状1例并文献回顾[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 126-130.
[3]	罗露,周恩,肖旭平,林志强,方志杰,吕晓虹. 等离子点状激发技术在儿童OSA扁桃体腺样体切除术联合围手术期快速康复中的应用[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 26-30.
[4]	张杰,陈敏,申征征,吴宇华,刘原虎,孙浩,谭新华,倪树仁,杨书勋,史雪峥,倪鑫. 过敏性鼻炎与儿童新冠病毒肺炎感染及症状的关联性研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 36-42.
[5]	张晓,刘海红,刘薇,李颖,陈敏,刘冰,白杰,张杰,郑军,杨扬. 先天性单侧聋患儿112例临床资料分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 96-196.
[6]	赵云,滕支盼,李琦,沈小飞. 儿童腺样体扁桃体切除后圆枕增生26例[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 43-48.
[7]	鲁欢,何本超,廖红明. 儿童急性鼻窦炎合并眶眼蜂窝织炎并发颅内感染1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 46-50.
[8]	王亚芳,赵海涛,王娟,刘晓峰,阎玉彦,温鑫. 以喉鸣为首发症状儿童喉结核1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 51-53.
[9]	陈坤,陆慧,李磊,张帆,杨军,黄琦. 累及儿童多部位的浆细胞型Castleman病1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 54-58.
[10]	张一彤,李青香,石争浩,尚磊,袁钰淇,曹子讷,麻莉娜,刘海琴,任晓勇,施叶雯. 阻塞性睡眠呼吸暂停儿童睡眠结构研究及睡眠结构判读模型建立[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 126-132.
[11]	宗春琳,陆金标,杨勇,苏忠平,于擘. MDT联合翻转课堂在儿童OSA临床教学中的应用研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 139-144.
[12]	袁晨阳,冯晨,王岩,李延忠,房振胜. 儿童阻塞性睡眠呼吸暂停相关血液学指标的临床研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 145-152.
[13]	徐宏鸣,范文焱,浦诗磊,李晓艳. 儿童上颌窦后鼻孔息肉36例临床资料分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 159-163.
[14]	倪守洁,邹娟娟,郭瑞祥,韩莹莹,金霄雪,李延忠,王岩. 儿童头颅侧位片测量参数对腺样体肥大诊断价值的研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 39-44.
[15]	徐冬娇,田秀芬. 内镜下等离子射频消融术治疗儿童先天性梨状窝瘘232例[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 56-62.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed