摘要
目的探讨发际内弧形小切口切开复位内固定术治疗颧骨复合体骨折(ZCF)的疗效及安全性。方法选取2015年3月至2018年3月于该院就诊的100例需要进行切开复位内固定术治疗的ZCF患者作为研究对象,根据手术切口不同分为A组(以发际内弧形小切口为主)和B组(以头皮冠状切口为主),每组各50例。分析比较两组患者手术持续时间、术中出血量、平均切口长度、骨折愈合时间及总住院时间,根据视觉模拟评分法(VAS)评估患者术后不同时间点的疼痛度,术后3d结合面部三维CT重建评价患者骨折复位情况,术后6个月复诊软组织恢复情况、术后并发症及药物不良反应率。结果A组手术持续时间、住院时间、骨折愈合时间、总出血量和平均切口长度均低于B组,差异均有统计学意义(P<0.05);A组术后12、24、48h的VAS评分均低于B组,差异均有统计学意义(P<0.05);A组术后3d骨折复位情况和软组织恢复情况总优良率均为96.00%,高于B组的80.00和78.00%,差异均有统计学意义(P<0.05);A组手术并发症发生率为10.00%,低于B组的26.00%,差异有统计学意义(P<0.05)。结论发际内弧形小切口切开复位内固定术治疗ZCF,手术安全快捷,患者疼痛感弱,治疗效果和预后更好,并发症少。
Objective To explore the efficacy and safety of hairline arch small incision combined with open reduction and internal fixation in the treatment of zygomatic complex fractures(ZCF).Methods A total of 100 patients with ZCF who underwent open reduction and internal fixation in our hospital from March 2015 to March 2018 were selected and divided into group A(patients accepted arch small incisions within hairline)and group B(patients accepted coronal operative incisions)according to the different surgical incisions,with 50 cases in each group.The operation duration,intraoperative blood loss,mean incision length,fracture healing time and total hospital stay were analyzed and compared between the two groups.The visual analogue scale(VAS)was used to evaluate the pain at different time points after operation.Combination of facial computed tomography(CT)reconstruction was used to evaluate the fracture reduction at 3 d after operation.The soft tissues recovery and postoperative complications and adverse drug reactions rate were reviewed at 6 months after operation.Results The operation duration,hospital stay,fracture healing time,total blood loss volume and average incision length in group A were significantly lower than those of group B(P<0.05).The VAS scores in group A were significantly lower than those of group B at 12,24 and 48 h after operation(P<0.05).The total good rate of fracture reduction and soft tissues recovery in group A(all 96.00%)were significantly higher than those in group B(80.00%,78.00%)(P<0.05).The operative complications and adverse drug reactions rate in group A(10.00%)was significantly lower than that in group B(26.00%,P<0.05).Conclusion Hairline arch small incision combined with open reduction and internal fixation is safe and rapid for the treatment of ZCF,and it has weak pain,better treatment effects and prognosis,as well as fewer complications.
作者
叶晓明
孙朝阳
YE Xiaoming;SUN Chaoyang(Department of Stomatology,Pangang General Hospital,Panzhihua,Sichuan 617023,China)
出处
《检验医学与临床》
CAS
2019年第20期2985-2988,共4页
Laboratory Medicine and Clinic
关键词
颧骨复合体骨折
切开复位内固定术
弧形小切口
zygomatic complex fractures
open reduction and internal fixation
arch small incision
作者简介
叶晓明,男,副主任医师,主要从事口腔颌面外科方面的研究.
