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目的观察修补鼻中隔穿孔移植组织围手术期的生长愈合情况。方法对13例鼻中隔穿孔长径5～26mm,选用黏膜(中鼻甲黏膜、下鼻甲黏膜、口腔颊黏膜)或阔筋膜,以及自体鼻中隔骨板为移植材料。用两层移植黏膜或筋膜中间夹中隔骨板,而后将这三层组织嵌插于穿孔的鼻中隔黏膜间修补穿孔。结果穿孔长径在5～14mm大小之间用黏膜夹中隔骨板修补(下鼻甲黏膜修补2例;中鼻甲黏膜修补2例;口腔颊黏膜修补5例)。均在20天内愈合,其中有1例因移植物偏小,前端有小裂缝3mm,后进行二次修复。穿孔长径在15～26mm用筋膜包绕骨板修补4例,20～36d愈合。结论鼻中隔骨板包绕筋膜(或黏膜)嵌插修补法形成稳定移植环境,筋膜被生长的中隔黏骨膜覆盖,3种移植黏膜均保持原组织的特点,以颊黏膜组织最佳。
Objective To observe the perioperative growth and healing of repaired nasal septal perforation. Methods Thirteen cases of nasal septum perforation with a diameter of 5 ~ 26 mm were selected. The mucosa (middle turbinate mucosa, inferior turbinate mucosa, oral buccal mucosa) or the fascia lata was used, and the autologous nasal septum plate was used as the graft material. With two layers of mucosa or fascia medial folder septum plate, and then inserted into the three layers of tissue in the perforation of the nasal septum mucosa repair perforation. Results The length of perforation was fixed between 5 ~ 14mm in size with mucosal septum plate (2 cases of inferior turbinate mucosa repair, 2 cases of middle turbinate mucosa repair and 5 cases of oral buccal mucosa repair). All were healed within 20 days. One of the cases had a small size of the graft with a small crack in the front of 3 mm, and a second repair was performed after that. Perforation of the long diameter at 15 ~ 26mm with fascia wrapping plate repair in 4 cases, 20 ~ 36d healing. Conclusions The nasal septum plate wrapped around the fascia (or mucosa) is inserted and repaired to form a stable transplanted environment. The fascia is covered by the growing septal mucoperiosteum. The three kinds of transplanted mucosa retain the characteristics of the original tissue and the buccal mucosa is the best.