鼻中隔软骨联合耳软骨对鼻尖整形患者鼻部美学指标的影响

刘涛　郑本强　罗志平

[摘要]目的：分析鼻中隔軟骨联合耳软骨移植对鼻尖整形患者鼻部美学指标的影响。方法：以2019年1月-2020年2月笔者医院收治的鼻尖整形患者80例为研究对象，采用随机数字表法分为对照组和观察组，各40例。对照组采用膨体聚四氟乙烯假体进行整形，观察组采用鼻中隔软骨联合耳软骨移植，两组术后均随访6个月。统计两组出院时切口愈合情况，比较两组术前和术后6个月鼻部整形满意度和鼻部美学指标，统计两组住院期间并发症发生情况。结果：出院时，观察组切口Ⅰ级愈合率（62.50%）高于对照组（37.50%），Ⅲ级愈合率（10.00%）低于对照组（30.00%），差异有统计学意义（P<0.05）。与术前比较，术后6个月两组鼻形、鼻尖、鼻尖旋转度、鼻孔直径满意度评分升高，观察组高于对照组，差异有统计学意义（P<0.05）。与术前比较，术后6个月两组鼻长度、鼻尖高度、鼻尖突出度显著升高，观察组鼻尖突出度高于对照组，差异有统计学意义（P<0.05）。住院期间，观察组总并发症发生率为7.50%，显著低于对照组（25.00%），差异有统计学意义（P<0.05）。结论：鼻中隔软骨联合耳软骨移植进行鼻尖整形，可有效促进切口愈合，提高鼻部美学效果和患者满意度，同时降低术后并发症的发生，具有较好的安全性。

[关键词]鼻尖整形;鼻中隔软骨;耳软骨;膨体聚四氟乙烯;鼻部美学

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）09-0073-03

Effect of Nasal Septal Cartilage Combined with Ear Cartilage on Nasal Aesthetic Indicator in Patients with Nasal Tip Plastic Surgery

LIU Tao1，ZHENG Ben-qiang2，LUO Zhi-ping3

（1.Department of Otolaryngology;2.Department of Stomatology;3.Department of Obstetrics，Jingmen Second People's Hospital，Jingmen 448000，Hubei，China）

Abstract： Objective  To analyse the effect of septal cartilage combined with auricular cartilage transplantation on nasal aesthetic indicator of patients with nasal tip reconstruction. Methods  A total of 80 patients with nasal tip reconstruction admitted to our hospital from January 2019 to February 2020 were taken as the research objects， and they were divided into the control group and the observation group by random number table method， with 40 patients in each group. The control group was treated with expanded polytetrafluoroethylene prosthesis， the observation group was treated with septal cartilage combined with auricular cartilage transplantation. The two groups were followed up for 6 months after surgery. The incision healing of the two groups at the time of discharge was statistically analyzed， and the satisfaction with nasal plastic surgery and nasal aesthetic indicator pre-operation and 6 months after surgery were compared between the two groups. The incidence of complications during hospitalization was also statistically analyzed. Results  When discharged from hospital， the first-class healing rate （62.50%） in the observation group was higher than that in the control group （37.50%）， the difference was statistically significant（P<0.05）. While the third-class healing rate （10.00%） was lower than that in the control group （30.00%， P<0.05）. Compared with pre-operation， the satisfaction scores of nose shape， nose tip， nose tip rotation and nostril diameter in the two groups increased 6 months after surgery， and the observation group was higher than the control group （P<0.05）. Compared with pre-operation， the nose length， nose tip height and nose tip protrusion in the two groups were higher significantly 6 months after surgery， and the nose tip protrusion in the observation group was higher than that in the control group （P<0.05）. During hospitalization， the total complication rate of the observation group was 7.50%， which was significantly lower than that of the control group （25.00%， P<0.05）. Conclusion  Septal cartilage combined with auricular cartilage transplantation could effectively promote the healing of nasal tip， improve nasal aesthetics and patient satisfaction， and reduce postoperative complications， with better safety.

Key words： nose tip plastic surgery; nasal septal cartilage; auricular cartilage; expanded polytetrafluoroethylene; nose aesthetics

近年来，随着生活水平的提高，人们对面部美观的追求也越来越高。鼻部处于人面部的中心位置，在面部美观中占据重要地位，而鼻尖形态是鼻形美观的重要指标[1]。目前，改进患者鼻尖形态的手术方法包括膨体聚四氟乙烯假体、硅胶假体和自体软骨移植等，膨体聚四氟乙烯假体是目前临床应用最广泛的假体，但其具有无法承受较大外力刺激的缺点[2];自体软骨移植中的软骨主要来自鼻中隔和耳软骨，其所需软骨用量较少，并且可以提供良好的支撑力，有效改善患者鼻尖形态[3]，目前临床对于鼻中隔软骨联合耳软骨移植用于鼻尖整形的相关研究主要集中于降低术后并发症方面，较少对鼻部美学情况进行评价，基于此，本研究采用鼻中隔软骨联合耳软骨移植行鼻尖整形，分析其对患者鼻部美学指标的影响，现将结果报道如下。……