山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 31-34.doi: 10.6040/j.issn.1673-3770.0.2015.033

• 论著 • 上一篇    下一篇

个体化减张整形术与传统黏膜下切除术治疗鼻中隔偏曲的比较研究

李嘉, 黎雄文, 张鹏坚, 叶远航, 秦勇   

  1. 广东梅州市人民医院耳鼻咽喉科, 广东 梅州 514031
  • 收稿日期:2015-01-13 修回日期:2015-04-28 出版日期:2015-08-16 发布日期:2015-08-16
  • 作者简介:李嘉。E-mail:lijiacn@126.com

A comparative study on effect of the individual tension relaxing plasty versus traditional submucosal resection for deviation of the nasal septum.

LI Jia, LI Xiongwen, ZHANG Pengjian, YE Yuanhang, QIN Yong   

  1. Department of Otolaryngolngy, The People's Hospital of Meizhou, Meizhou 514031, Guangdong, China
  • Received:2015-01-13 Revised:2015-04-28 Online:2015-08-16 Published:2015-08-16

摘要: 目的 比较鼻中隔支架的个体化减张整形矫正术与传统黏膜下切除术治疗鼻中隔偏曲的效果。方法 采用病例对照的研究方法回顾分析2009年至2013年收治的鼻中隔偏曲160例的临床资料, 按病变部位及类型相似、年龄相差≤5岁, 1:1配对。随访12个月以上, 比较两组手术时间、术中出血量、术后鼻中隔血肿、术后疼痛、活瓣性鼻塞及原鼻塞症状改善情况。结果 研究组和对照组各纳入80例患者, 研究组手术时间为20~60(37.48±10.78)min, 对照组为20~55(34.66±10.86)min, 差异无统计学意义(t=1.644, P > 0.05);研究组术中出血量为3~15(9.38±3.02)mL, 对照组为5~20(11.59±4.71)mL, 研究组少于对照组(t;=-3.536, P < 0.01);两组术后疼痛以中等疼痛为主, 第1天最重, 研究组为2~6(4.59±0.82)分, 对照组为3~7 (4.95±0.86)分(t=-2.733, P < 0.01);第2天研究组为1~5(2.93±0.65)分, 对照组为2~5 (3.43±0.71)分(t=-4.649, P < 0.01), 差异均有统计学意义;第3天开始症状趋于平缓, 研究组为1~2(1.55±0.50)分, 对照组为1~3(1.69±0.52)分, 差异无统计学意义(t=-1.707, P > 0.05)。术后并发症:研究组有1例鼻中隔血肿(1/80), 对照组出现5例(χ2=1.558 4, P > 0.05),差异无统计学意义;研究组无术后活瓣性鼻塞, 对照组随访中出现6例(6/80), 差异有统计学意义(χ2=4.329, P < 0.05);研究组鼻塞症状均消失, 对照组随访中发现轻度鼻塞6例(6/80), 差异有统计学意义(χ2=4.329, P < 0.05)。结论 与传统黏膜下切除术相比, 个体化减张整形矫正术未明显延长手术时间, 术中出血较少, 术后疼痛较轻, 并发症较少。

关键词: 鼻中隔偏曲, 鼻中隔整形, 个体化治疗, 减张, 鼻中隔成形术

Abstract: Objective To compare the effect of nasal septum support individual tension relaxing plasty with traditional submucousal resection for nasal septum deviation. Methods A case-control study was made on patients with deviation of nasal septum treated in our department during 2009 to 2013. Based on the lesion site, similar type and age difference of less than 5 years, 80 patients in the study group and 80 in the control group were one to one matched in this study. Followed up over 12 months, the operation time, intra-operative bleeding, post-operative nasal septal hematoma, post-operative pain, stuffy nose and nasal valve of the original symptom improvement were compared. Results The operation time was 20-60 (37.48±10.78) minutes in the study group and 20-55(34.66±10.86) minutes in the control group (t=1.644, P>0.05). The intra-operative bleeding was 3-15(9.38±3.02) mL in the study group and 5-20 (11.59±4.71) mL in the control group (t=-3.536, P<0.01). The post-operative pain was moderate in the two groups and it was the most on the first day 2-6 (4.59±0.82) points in the study group and 3-7 (4.95±0.86) points in the control group (t=-2.733, P<0.01), on the second day 1-5 (2.93±0.65) points in the study group and 2-5 (3.43±0.71) points in the control group (t=-4.649, P<0.01), on the third day 1-2 (1.55±0.50) points in the study group and 1-3 (1.69±0.52) points in the control group (t=-1.707, P>0.05). Post-operative complications: nasal septum hematoma, 1 case in the study group (1/80) while 5 in the control group (χ2=1.558 4, P>0.05); valvular nasal obstruction, none in the study group while 6 (6/80) in the control group (χ2=4.329, P<0.05); nasal obstruction, none in the study group while 6 in the control group (χ2=4.329, P<0.05). Conclusion Compared with traditional submucosal resection, individual tension plastic correction has advantages of less intra-operative bleeding and post-operative pain and fewer complications in the deviation of nasal septum treatment.

Key words: Individual therapy, Plastic nasal septum, Nasal septum plasty, Deviation of nasal septum, Tension relaxing

中图分类号: 

  • R765.3+1
[1] 韩德民, 王彤, 臧洪瑞.三线减张鼻中隔矫正术[J].中国医学文摘:耳鼻咽喉科学, 2009, 24(2):103-105. HAN Demin, WANG Tong, ZANG Hongrui. Three line tension relaxing method for nasal septal reconstruction[J]. Chin ENT News Rev, 2009, 24(2):103-105.
[2] Cantrell H. Limited septoplasty for endoscopic sinus surgery[J]. Otolaryngol Head Neck Surg, 1997, 116(2):274-277.
[3] Van Loosen J, Van Zanten G A, Howard C V, et al. Growth characteristics of the human nasal septum[J]. Rhinology, 1996, 34(2):78-82.
[4] 王丰, 周成勇.鼻内镜下四线减张法治疗歪鼻的疗效观察[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47(3):241-243. WANG Feng, ZHOU Chengyong. Effect of four line tension relaxing for nasal deviation rectification under endoscope[J]. Chin Otolaryngol Head Neck Surg, 2012, 47(3):241-243.
[1] 李帅,黄春燕,常明章. 鼻内镜下鼻中隔软骨尾端偏曲矫正术的临床效果分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 65-70.
[2] 杜康丽,郑振宇,徐战将,张宇,陈露,卢梦垚. 鼻中隔偏曲并发慢性鼻窦炎风险预测模型的构建与验证[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 78-86.
[3] 曾宪廷,王广科,孙占伟,武天义,李世超,王卫卫. 伴咽喉反流的难治性鼻窦炎术后应用质子泵抑制剂的疗效观察[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 189-194.
[4] 孙笑晗,李娜,陈凯璇,陈敏,闫舒,车飞. ROE量表在外鼻畸形合并鼻中隔偏曲患者手术前后生存质量评估中的应用[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 87-91.
[5] 徐建慧,李欣,寸晶晶,叶飞. 加速康复外科在鼻中隔偏曲矫正术围手术期的应用效果[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 21-24.
[6] 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.
[7] 王海英. 鼻内镜下二线减张鼻中隔矫正术43例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 166-168.
[8] 崔晓波. 诱导化疗在局部晚期下咽癌治疗中的意义[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 10-17.
[9] 陈望兴,赵雪,刘岩,刘悦,金春顺. 鼻中隔偏曲及慢性鼻窦炎鼻息肉患者的精神心理状态调查[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 24-27.
[10] 代亚错,李靖,万保罗,臧艳姿,黄颖铭. 个体化治疗咽喉部海绵状血管瘤二例[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 110-112.
[11] 王磊, 袁英, 于学民, 韩玉娥, 王宁, 李晓, 李泽晶, 李龙. 鼻中隔连续贯穿缝合技术在鼻中隔偏曲矫正术中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 73-75.
[12] 李娜. 美容与功能兼顾——浅谈鼻畸形整复与鼻中隔成形术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 1-2.
[13] 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.
[14] 张维天, 茆松. 鼻整形术:歪鼻整形[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 10-13.
[15] 华骋, 陈振雨,张维娜,李娜. 鼻内镜辅助下外鼻整形同期鼻中隔偏曲矫正术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 33-36.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!