自体肋软骨与膨体聚四氟乙烯假体行鼻整形术疗效比较

胡纯兵 陈国双 王亮

[摘要]目的：探討自体肋软骨与膨体聚四氟乙烯假体在鼻部整形术中的效果。方法：选择2015年9月-2017年9月于笔者医院进行治疗的鼻部整形患者160例作为研究对象，根据修复材料分为观察组（n=81）和对照组（n=79），对照组使用膨体聚四氟乙烯假体隆鼻，观察组采用自体肋软骨隆鼻。比较两组手术成功率、愈合时间、鼻尖突出度、鼻背长度、小柱-小叶比、鼻额角、鼻根部的鼻梁高度、满意度及并发症发生情况。结果：治疗后，观察组手术成功率、鼻尖突出度[100.00%、（0.59±0.06）cm]均高于对照组[88.61%、（0.46±0.05）cm]，愈合时间（8.24±1.56）d显著低于对照组（11.24±1.93）d，差异具有统计学意义（P<0.05）。观察组鼻背长度、小柱-小叶比及鼻根部的鼻梁高度[（43.15±4.31）mm、1.87±0.13、（12.87±1.56）mm]均高于对照组[（41.17±4.12）mm、1.61±0.31、（12.04±1.21）mm]，鼻额角（121.25±6.13）°显著低于对照组（136.54±7.98）°，差异具有统计学意义（P<0.05）。观察组患者满意度为92.59%，显著高于对照组的68.35%，差异具有统计学意义（P<0.05）。观察组并发症总发生率为3.70%低于对照组的20.25%，差异具有统计学意义（P<0.05）。结论：在鼻部整形患者中使用自体肋软骨隆鼻效果显著，可有效改善患者满意度及愈合时间，值得推广应用。

[关键词]自体肋软骨;膨体聚四氟乙烯;鼻整形术;鼻部形态;满意度;并发症

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）04-0018-04

Comparison of the Effect of Autogenous Costal Cartilage and Expanded Polytetrafluoroethylene Prosthesis in Rhinoplasty

HU Chun-bing，CHEN Guo-shuang，WANG Liang

（Department of Plastic and Reconstructive Surgery，Yuehao Cosmetic Hospital，Chengdu 610036，Sichuan，China）

Abstract： Objective  To study comparison of the effect of autogenous costal cartilage and expanded polytetrafluoroethylene prosthesis in rhinoplasty. Methods  160 patients with rhinoplasty who were treated in our hospital from September 2015 to September 2017 were selected as the research objects. According to the repair materials， they were divided into the observation group （n=81） and the control group （n=79）. The control group was treated with expanded polytetrafronide prosthesis for rhinoplasty， and the observation group was treated with autologous costal cartilage for rhinoplasty. The operation success rate， healing time， nasal tip protrusion， nasal dorsal length， column-lobule ratio， nasal frontal Angle， nasal bridge height， satisfaction and complications were compared between the two groups. Results  After treatment， the operative success rate and nasal tip protrusion [100.00%， （0.59±0.06）cm] in the observation group were all higher than those in the control group [88.61%， （0.46±0.05）cm]， and the healing time （8.24±1.56）d was significantly lower than that in the control group （11.24±1.93）d. The differences were statistically significant （P<0.05）. After treatment， the nasal dorsal length， column-lobules ratio and nasal bridge height [（43.15±4.31）mm， 1.87±0.13， （12.87±1.56）mm] in the observation group were all higher than those of the control group [（41.17±4.12）mm， 1.61±0.31， （12.04±1.21）mm]， and the nasal frontal Angle （121.25±6.13）° was significantly lower than that in the control group （136.54±7.98）°， with the differences were statistically significant （P<0.05）. The satisfaction of patients in the observation group was 92.59%， significantly higher than that in the control group （68.35%， P<0.05）. The total incidence of complications in the observation group was 3.70%， which was lower than that in the control group（20.25%， P<0.05）. Conclusion  The use of autologous costal cartilage in rhinoplasty patients has a significant effect on augmentation of the nose， which can effectively improve patient satisfaction and healing time.

Key words： autologous costal cartilage; expanded polytetrafluoroethylene; rhinoplasty; nasal morphology; satisfaction; complications

随着经济的发展及生活水平的提高，越来越多人加入求美的行列，面部整形率逐年提高，鼻为面部正中部位，鼻形的美观直接影响面部美学[1]。鼻整形在整形外科中十分常见，鼻整形术可以改变鼻子的大小，改变鼻梁外观，缩小鼻翼延伸，使面中部具有立体感[2-3]。目前对于鼻部整形通常采用固体硅胶假体、聚四氟乙烯等材料，可以满足大多数患者的需要，但对于不能接受假体或多发性鼻整形失败的患者，隆鼻术后常常存在不同程度的并发症[4]。近年来，有研究显示，自体肋软骨在鼻部整形中有不错的效果，降低了并发症发生率[5]。自体肋软骨取材简单，可根据患者鼻形特点进行雕刻，满足鼻整形需求，且无排斥反应、支撑力强，可广泛运用于鼻部整形中[6-7]。……