论文部分内容阅读
目的:提高急诊鼻骨骨折患者的疗效。方法:回顾性分析154例鼻外伤致鼻骨骨折患者。根据病史和体检,结合影像学检查确诊。根据伤情分类,分别行清创术,止血、抗感染、消肿治疗术,各种鼻骨骨折整复术、上颌骨额突骨折整复术、鼻窦骨折整复术和鼻中隔矫正术以及鼻中隔血肿清除术。结果:①诊断:X线鼻骨侧位片确诊123例,占确诊例数79.9%;X线检查未见明显骨折而行CT扫描确诊31例,占确诊例数20.1%。②治疗:治愈132例,占总研究例数85.7%;好转15例,占总研究例数9.75%;其他:拟Ⅱ期复位1例,占总研究例数0.65%。严重的复合伤失访2例,占总研究例数1.3%。放弃治疗4例,占总研究例数2.6%。好转病例中,10例X线拍片未见骨折,伤后12～14d鼻部CT发现鼻骨骨折和(或)上颌骨额突骨折,行闭合性鼻骨骨折整复术和(或)上颌骨额突骨折整复术,占好转病例66.7%;3例粉碎性鼻骨骨折患者行闭合性鼻骨骨折整复术,占好转病例20%;陈旧性骨折重新复位2例,占好转病例13.3%。结论:对于有明确鼻部外伤史且外鼻畸形明显患者,X线检查未见明显骨折征象时,应行CT扫描,尽早确诊、及时治疗,以期提高骨折治愈率;同时还应关注鼻腔内部结构的损伤,鼻骨整复术同时及时处理,以免遗留外形缺损和功能障碍;不同骨折类型选择不同的治疗开始时间和治疗方案对于提高治疗治愈率有帮助。
Objective: To improve the efficacy of emergency nasal fracture patients. Methods: A retrospective analysis of 154 cases of nasal injury caused by nasal fracture patients. According to medical history and physical examination, combined with imaging diagnosis. According to the classification of injuries, respectively, debridement, hemostasis, anti-infective, swelling treatment, a variety of nasal bone fractures, maxillary frontal extension fracture surgery, sinus surgery and nasal septum correction and nasal septum hematoma Clear surgery. Results: ① Diagnosis: X-ray nasal lateral pelvic diagnosis of 123 cases, accounting for 79.9% of the confirmed cases; X-ray examination without obvious fracture CT scan confirmed 31 cases, accounting for 20.1% of confirmed cases. ② Treatment: cured 132 cases, accounting for 85.7% of the total number of cases; improved in 15 cases, accounting for 9.75% of the total number of cases; other: quasi-phase Ⅱ reset in 1 case, accounting for 0.65% of the total number of cases. Serious composite injury in 2 cases, accounting for 1.3% of the total number of cases. Give up treatment in 4 cases, the total number of cases 2.6%. Improvement cases, 10 cases of X-ray film did not fracture, 12-14 days after injury nasal CT nasal bone fracture and / or maxillary frontal fracture, line closure of the nasal bone fractures and (or) the maxillary frontal process Fracture repair surgery, accounting for 66.7% of cases improved; 3 cases of comminuted nasal fracture patients closed closed nasal bone fracture surgery, accounting for 20% of cases of improvement; old fractures in 2 cases, 13.3% of the cases accounted for. Conclusion: For patients with clear history of nasal trauma and obvious external nasal deformities, X-ray examination without obvious signs of fracture should be performed CT scan as soon as possible, and timely treatment, in order to improve the cure rate of fracture; also should pay attention to the internal structure of the nasal cavity Of the injury, nasal bone surgery at the same time timely treatment, so as to avoid the appearance of defects and dysfunction; different fracture types to choose a different treatment start time and treatment options for improving the cure rate.