联合切口结合内镜辅助治疗颧骨颧弓骨折临床效果分析
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摘要
目的:探讨联合切口结合内镜辅助治疗颧骨颧弓骨折的临床效果。方法:选取2016年1月-2018年9月在笔者医院接受治疗的56例颧骨颧弓骨折患者,按随机数字表法将其分为实验组和对照组,每组28例。实验组采用联合切口内镜辅助下颧弓骨折切开复位内固定治疗,对照组采用联合切口结合微型钛板治疗。比较两组治疗效果、术后3个月双侧颧弓突度差值及面部软组织对称性评分、术后并发症和患者满意度。结果:两组患者骨折断端复位良好,伤口均达到一期愈合。两组患者术后3个月双侧颧弓突度差值无显著性差异[(1.21±0.32)mmvs(1.40±0.41)mm](P>0.05)。与术前比较,术后3个月两组患者面部软组织对称性评分均明显降低,且两组间无显著性差异[(2.22±0.85)分vs(2.18±1.10)分](P>0.05)。两组总并发症发生率无明显差异[10.71%vs14.29%](P>0.05)。两组患者对术后颧弓外形、面部外形、张口受限及术后反应满意度评分均无显著性差异[(8.14±1.11)分vs(8.23±1.05分)、(8.43±1.02)分vs(8.08±1.33)分、(8.50±1.14)分vs(8.73±1.42)分、(8.65±1.23)分vs(8.89±1.10)分](P>0.05)。结论:联合切口内镜辅助下颧弓骨折切开复位内固定治疗颧骨颧弓骨折均可明显改善患者面部软组织对称性,平衡双侧颧弓突度,提高患者满意度,临床效果较好,安全性高。
Objective To investigate the clinical effect of combined incision and micro titanium plate in treatment of comminuted zygoma fracture. Methods 56 patients with comminuted zygoma fracture treated in our hospital from January 2016 to September 2018 were selected and divided into the experiment group and the control group according to the random number table method, 28 cases in each group. The experiment group was treated with combined incision and endoscopic assisted zygomatic arch fracture open reduction and internal fixation, the control group was treated with combined incision and micro titanium plate, the therapeutic effects, the difference of bilateral zygoma margin and the facial soft tissue symmetry scores,postoperative complications and patient satisfaction of the 2 groups were compared. Results The fracture ends were well restored of the 2 groups, and the wounds all reached the first stage of healing. The difference of bilateral zygoma margin at 3 months after the operation had no statistical difference between the 2 groups [(1.21±0.32) mm vs(1.40±0.41) mm](P>0.05).Compared with preoperation, the facial soft tissue symmetry scores of the 2 groups significantly decreased at 3 months after the operation, and there was no statistical difference between the 2 groups [(2.22±0.85) scores vs(2.18±1.10) scores](P>0.05). The incidence of total complications had no statistical difference between the 2 groups [10.71% vs 14.29%](P>0.05).The satisfaction scores of posterior zygomatic arch shape, facial shape, mouth opening restriction and postoperative response had no statistical difference between the 2 groups [(8.14±1.11) scores vs(8.23±1.05) scores,(8.43±1.02) scores vs(8.08±1.33)scores,(8.50±1.14) scores vs(8.73±1.42) scores,(8.65±1.23) scores vs(8.89±1.10) scores](P>0.05). Conclusion Combined incision combined with endoscopic assisted zygomatic arch fracture open reduction and internal fixation for the treatment of comminuted zygoma fracture can significantly improve the facial soft tissue symmetry, balance the bilateral sacral arch protrusion, improve patient satisfaction, the clinical effect is good, and it has high safety.
Objective To investigate the clinical effect of combined incision and micro titanium plate in treatment of comminuted zygoma fracture. Methods 56 patients with comminuted zygoma fracture treated in our hospital from January 2016 to September 2018 were selected and divided into the experiment group and the control group according to the random number table method, 28 cases in each group. The experiment group was treated with combined incision and endoscopic assisted zygomatic arch fracture open reduction and internal fixation, the control group was treated with combined incision and micro titanium plate, the therapeutic effects, the difference of bilateral zygoma margin and the facial soft tissue symmetry scores,postoperative complications and patient satisfaction of the 2 groups were compared. Results The fracture ends were well restored of the 2 groups, and the wounds all reached the first stage of healing. The difference of bilateral zygoma margin at 3 months after the operation had no statistical difference between the 2 groups [(1.21±0.32) mm vs(1.40±0.41) mm](P>0.05).Compared with preoperation, the facial soft tissue symmetry scores of the 2 groups significantly decreased at 3 months after the operation, and there was no statistical difference between the 2 groups [(2.22±0.85) scores vs(2.18±1.10) scores](P>0.05). The incidence of total complications had no statistical difference between the 2 groups [10.71% vs 14.29%](P>0.05).The satisfaction scores of posterior zygomatic arch shape, facial shape, mouth opening restriction and postoperative response had no statistical difference between the 2 groups [(8.14±1.11) scores vs(8.23±1.05) scores,(8.43±1.02) scores vs(8.08±1.33)scores,(8.50±1.14) scores vs(8.73±1.42) scores,(8.65±1.23) scores vs(8.89±1.10) scores](P>0.05). Conclusion Combined incision combined with endoscopic assisted zygomatic arch fracture open reduction and internal fixation for the treatment of comminuted zygoma fracture can significantly improve the facial soft tissue symmetry, balance the bilateral sacral arch protrusion, improve patient satisfaction, the clinical effect is good, and it has high safety.
引文
[1]章宏毅,彭国栋,佘小伟,等.改良耳颞切口在颧骨颧弓骨折患者开放复位手术中的应用[J].中华医学美学美容杂志,2015,21(3):133-135.
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[10]Bujtár P,Steele P,Holland I,et al.Buttress guide:direct positioning splint to align a complex fracture of the zygoma[J].Br J Oral Maxillofac Surg,2016,55(1):97-99.
[11]汪松.五种骨外固定器的结构稳定性评估和骨折精确闭合复位效果评价[D].天津:天津医科大学,2016.
[12]巢阳,舒越昆,陈力,等.眼眶骨折微型钛板塑形内固定整复术的疗效观察[J].西南国防医药,2014,24(11):1210-1212.
[13]林钊锐.联合切口结合微型钛板在颧骨颧弓骨折治疗中的应用[J].海南医学,2017,28(15):2538-2539.
[2]段文锴.冠状切口入路治疗颧骨颧弓骨折的临床效果分析[J].中国实用医药,2016,11(11):90-91.
[3]张辉秋,孙连碧.微创切口治疗颧骨颧弓骨折[J].临床军医杂志,2015,43(4):431-433.
[4]胡超,肖金刚,胡文健,等.颌间牵引钉联合小型或微型钛板内固定修复颌骨骨折[J].中国组织工程研究,2016,20(11):1610-1615.
[5]邱蔚六,张震康.口腔颌面外科学[M].5版.北京:人民卫生出版社,2003:197.
[6]依沙克江·买买提.颧骨颧弓骨折342例回顾性研究[D].乌鲁木齐:新疆医科大学,2014.
[7]Kang DH,Jung DW,Kim YH,et al.Kirschner wire fixation for the treatment of comminuted zygomatic fractures[J].Arch Craniofac Surg,2015,16(3):119-124.
[8]骆琦,肖文芝,陈涌,等.内镜辅助下颧弓骨折切开复位内固定治疗的临床研究[J].华西口腔医学杂志,2016,34(2):166-168.
[9]刘正武,郑灵,丘小丽,等.冠状切口入路治疗颧骨颧弓骨折146例临床分析[J].广西医科大学学报,2014,31(4):653-655.
[10]Bujtár P,Steele P,Holland I,et al.Buttress guide:direct positioning splint to align a complex fracture of the zygoma[J].Br J Oral Maxillofac Surg,2016,55(1):97-99.
[11]汪松.五种骨外固定器的结构稳定性评估和骨折精确闭合复位效果评价[D].天津:天津医科大学,2016.
[12]巢阳,舒越昆,陈力,等.眼眶骨折微型钛板塑形内固定整复术的疗效观察[J].西南国防医药,2014,24(11):1210-1212.
[13]林钊锐.联合切口结合微型钛板在颧骨颧弓骨折治疗中的应用[J].海南医学,2017,28(15):2538-2539.
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