两种鼻骨复位器在鼻骨复位术中的应用研究

Clinical study on application of two nasal bone reduction devices in nasal bone reduction

摘要:

目的 探究3D打印鼻骨复位器在鼻骨复位术中的安全性和有效性。方法 收集2017年11月—2020年6月在上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科接受手术治疗的鼻骨骨折患者85例。随机分为两组，对照组（41例）术中使用传统鼻骨复位器，实验组（44例）术中使用3D打印鼻骨复位器；最终对照组和实验组纳入分析各39例。应用视觉模拟评分法评估患者术前和术后的主观评分，根据术后CT评估术后疗效。结果 对照组术前外形评分（6±3）分，术前鼻塞评分（3±3）分；实验组术前外形评分（6±4）分，术前鼻塞评分（3±4）分。对照组术后外形评分（2±2）分，术后鼻塞评分（1±1）分；实验组术后外形评分（1±2）分，术后鼻塞评分（1±0）分。对照组术后疗效显示“极好”23例，“好”13例，“一般”3例；实验组术后疗效显示“极好”32例，“好”6例，“一般”1例。结论 在鼻骨复位术中使用3D打印鼻骨复位器和传统鼻骨复位器都能显著改善患者的鼻外形和通气功能，使用3D打印鼻骨复位器更容易做到鼻骨骨折的精准解剖复位。

关键词:鼻骨;闭合骨折复位;3D打印

Abstract:

Objective To investigate the safety and efficacy of 3D printing nasal bone reduction device in closed reduction. Methods Eighty-five cases of nasal bone fracture were consecutively enrolled in our department from Nov 2017 to June 2020. Of them, 41 treated with traditional nasal bone reduction device were assigned to the control group and 44 patients treated with 3D printing nasal bone device to the experimental group. Clinical data of 39 patients in the control group and 39 in the experimental group were eventually analyzed. Visual analogue score (VAS) was used to evaluate the patient satisfaction. The surgical effect was classified as ‘excellent’, ‘good’ and ‘fair’ according to postoperative CT scans. Results The preoperative appearance score and nasal congestion score were 6±3 and 3±3 in the control group, 6±4 and 3±4 in the experimental group. The postoperative appearance score and nasal congestion score were 2±2 and 1±1 in the control group, 1±2 and 1±0 in the experimental group. As for the surgical effect, 23 cases were shown as ‘excellent’, 13 as ‘good’, and 3 as ‘fair’ in the control group, and the case numbers of ‘excellent’, ‘good’ and ‘fair’ were 32, 6 and 1 in the experimental group. Conclusions Either 3D printing nasal bone reduction device or traditional nasal bone reduction device can greatly improve patients' nasal appearance and ventilation in closed reduction. It is easier to achieve accurate anatomical reduction of nasal bone fracture by using 3D printing nasal bone reduction device.

Key words:Nasal bone;Closed fracture reduction;3D printing