不同移植体在鼻尖整形术中的应用效果比较

刘江 陈小芳 曾开达

[摘要]目的：探討不同移植体在鼻尖整形手术中的应用效果，并分析术后并发症情况。方法：选取2019年3月-2020年3月在笔者医院行鼻尖整形的患者129例。按随机数字法和患者意愿分为膨体聚四氟乙烯（e-PTFE）组、e-PTFE+耳软骨组、e-PTFE+肋软骨组3组，各43例。比较三组临床资料、手术情况、临床效果、手术满意度及并发症情况。结果：三组患者基本资料、手术时间及愈合时间比较，差异均无统计学意义（P>0.05）。e-PTFE+耳软骨组、e-PTFE+肋软骨组鼻尖高度、鼻长度、鼻尖突出度均高于e-PTFE组，且e-PTFE+肋软骨组高于e-PTFE+耳软骨组，差异有统计学意义（P<0.05）。e-PTFE+耳软骨组、e-PTFE+肋软骨组总满意度均高于e-PTFE组，且e-PTFE+肋软骨组高于e-PTFE+耳软骨组，差异有统计学意义（P<0.05）。e-PTFE+耳软骨组、e-PTFE+肋软骨组并发症总发生率均低于e-PTFE组，且e-PTFE+肋软骨组低于e-PTFE+耳软骨组，差异有统计学意义（P<0.05）。结论：与单一应用e-PTFE相比，e-PTFE联合自体软骨在鼻尖整形手术中具有更优的效果，且e-PTFE联合自体肋软骨更能提高鼻尖整形效果，并发症少，患者满意度高，值得临床推广应用。

[关键词]鼻尖整形;膨体聚四氟乙烯;自体耳软骨;自体肋软骨;并发症;满意度;应用效果

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）07-0036-04

Comparison of Different Grafts in Nasal Tip Plastic Surgery

LIU Jiang1，CHEN Xiao-fang2，ZENG Kai-da1

（1.Hainan Korean American Medical Beauty Hospital，Haikou 570100，Hainan，China;2.Hunan Korean American Medical Beauty Clinic，Changsha 410000，Hunan，China）

Abstract： Objective  To investigate the application effect of different grafts in nasal tip plastic surgery， and analyze the postoperative complications. Methods  Total of 129 patients who underwent nasal tip plastic surgery in our hospital from March 2019 to March 2020 were selected. According to the random number method and the patient's wishes， the patients were divided into the 3 groups： the expanded polytetrafluoroethylene （e-PTFE） group （n=43）， the e-PTFE+ear cartilage group （n=43） and the e-PTFE+costal cartilage group （n=43）. The clinical data， surgical conditions， clinical effects， surgical satisfaction and complications of the 3 groups were compared. Results  There was no significant difference in basic information， operation time and healing time between the 3 groups （P>0.05）. The nasal tip height， nose length， nasal tip protrusion degree in the e-PTFE+ear cartilage group and the e-PTFE+costal cartilage group were higher than that in the e-PTFE group， and the e-PTFE+costal cartilage group was higher than that in the e-PTFE+ear cartilage group， and the difference were all statistically significant （P<0.05）. The total satisfaction of the e-PTFE+ear cartilage group and the e-PTFE+costal cartilage group were higher than that of the e-PTFE group， and the total satisfaction of the e-PTFE+costal cartilage group was higher than that of the e-PTFE+ear cartilage group， and the difference were all statistically significant （P<0.05）. The total incidence of complications in the e-PTFE+ear cartilage group and the e-PTFE+costal cartilage group were lower than that of the e-PTFE group， and the total incidence of complications in the e-PTFE+costal cartilage group was lower than that of the e-PTFE+ear cartilage group， and the difference were all statistically significant （P<0.05）. Conclusion  Compared with a single application of e-PTFE， e-PTFE combined with autologous cartilage has better effect in nasal tip plastic surgery， and e-PTFE combined with autologous costal cartilage can improve the effect of nasal tip plastic surgery， with less complications and high patient satisfaction， which is worthy of clinical application.

Key words： nasal tip plastic surgery; expanded polytetrafluoroethylene; autogenous ear cartilage; autogenous costal cartilage; complication; satisfaction degree; application effect

鼻部作為整体面部视觉的关键组成部位，可对外观面貌起到决定性作用。随着社会的持续发展，人们对美的需求不断提高，鼻尖整形手术日益受到人们的重视。通过鼻尖整形手术可纠正患者鼻形，增加鼻部美观性，已在临床广泛应用，取得了良好效果[1-2]。然而，一旦在鼻整形术中选材不合适，则容易引起感染、发红等不良现象，对手术效果造成一定影响[3]。因此，临床上有必要对鼻整形患者应用安全有效的材料。目前，鼻尖整形术常采用膨体聚四氟乙烯（Expanded polytetrafluoroethylene，e-PTFE）、自体软骨等材料进行填充。e-PTFE是一种高分子软组织材料，其生物性能稳定、外形弧度自然、可塑性好，在鼻整形术中发挥着重要作用[4]。自体软骨是来源于本身的软骨组织，临床应用以耳软骨、肋软骨为主，具有取材简单、无排斥反应、组织易成活等特点[5]。鼻尖……