高频超声可视化监测下鼻骨骨折闭合性复位的临床分析

Clinical analysis of closed reduction of nasal bone fractures using high-frequency ultrasound visualization monitoring

摘要:

目的 探讨在闭合性鼻骨骨折复位治疗中利用超声全程动态可视化监测的临床应用价值及实施手法复位治疗闭合性鼻骨骨折的实际效果。方法 本项研究选用蚌埠医科大学第一附属医院收治的84例闭合性鼻骨骨折患者，根据手术方式的不同将患者分为超声监测组(超声组)与传统法复位治疗组(传统组)两组。超声组采用在全程超声动态可视化监测下对鼻骨骨折行闭合性复位治疗，传统组采用传统的手法整复的方式行鼻骨骨折闭合性复位治疗。通过对术后CT影像评分、鼻部外形恢复情况以及鼻通气视觉模拟评估量表(VAS)评估鼻腔通气功能的数据对比两种整复方法的治疗效果。结果 超声组42例患者均快速进行了精准的手法复位治疗。超声组术后CT影像评分和鼻部结构、外形恢复情况以及VAS鼻通气评分均优于传统组，差异具有统计学意义(P均<0.05)。结论 全程超声动态可视化监测应用于新鲜鼻骨骨折闭合性复位，使得鼻骨骨折闭合性复位由原本传统的盲视下操作转变为在超声可视化下快速、精准操作，既提高了复位准确率、术后CT评分，又避免了鼻腔填塞导致的骨折片移位，改善了鼻腔通气功能，从而获得更高的患者满意度，使临床上针对不同鼻骨骨折类型制定个体化诊疗方案成为可能。

Abstract:

Objective To explore the clinical application value of using whole-course dynamic visualization monitoring by ultrasound in the reduction treatment of closed nasal bone fractures, as well as evaluate the practical effectiveness of manual reduction for closed nasal bone fractures. Methods This study enrolled 84 patients with closed nasal bone fractures admitted to the First Affiliated Hospital of Bengbu Medical University. According to different surgical methods, the patients were divided into two groups: the ultrasound monitoring group (ultrasound group) and the traditional manual reduction treatment group (traditional group). The ultrasound group performed closed reduction of nasal bone fractures was performed under dynamic visual monitoring by ultrasound throughout the procedure, while the traditional group underwent closed reduction of nasal bone fractures using traditional manual reduction methods. The effects of two groups were evaluated by comparing data of postoperative CT imaging scores, nasal contour recovery, and self-made VAS nasal ventilation scores. Results In the ultrasound group, all 42 patients under general anesthesia underwent rapid and precise manual reduction treatment. The postoperative CT imaging scores, recovery of nasal structure and contour, and nasal ventilation function (VAS nasal ventilation scores) in the ultrasound group were all superior to those in the traditional group. There was a statistically significant difference between the two groups (all P<0.05). Conclusions The application of whole-course dynamic ultrasound visualization monitoring in closed reduction of fresh nasal bone fractures transforms the traditional blind operation into a rapid and precise procedure under ultrasound visualization. This not only improves the reduction accuracy and postoperative CT scores but also avoids fracture fragment displacement caused by nasal packing and enhances nasal ventilation function, thereby achieving higher patient satisfaction. This also makes it possible to formulate individualized diagnosis and treatment plans for different fracture types in clinical practice.