李继银

[摘要]目的：探討自体肋软骨移植构建鼻尖复合体在鼻尖整形中的应用。方法：选取2016年6月-2017年6月于笔者医院行隆鼻整形的90例就医者为研究对象，采用配对比较法将其分为采取自体肋软骨移植构建鼻尖复合体整形的肋软骨组和采取膨体聚四氟乙烯鼻尖复合体整形的假体组，每组45例。对比两组手术效果和并发症发生率。结果：肋软骨组和假体组手术成功率分别为100.0%和97.8%，差异无统计学意义（P>0.05）。两组术后切口愈合时间比较，差异无统计学意义（P>0.05）。肋软骨组鼻尖突出度高于假体组，差异有统计学意义（P<0.05）。肋软骨组就医者对手术效果的各项满意度（鼻尖下小叶饱满度、鼻形、鼻孔直径、鼻尖旋转度）评分均高于假体组，综合满意度为88.9%，高于假体组的71.1%，差异有统计学意义（P<0.05）。肋软骨组术后慢性感染、肿胀发生率低于假体组，差异有统计学意义（P<0.05）。结论：自体肋软骨移植构建鼻尖复合体可以提高鼻尖突出度和就医者综合满意度，降低术后感染、变形等并发症发生率，值得在鼻部整形中推广应用。

[关键词]自体肋软骨；鼻尖复合体；鼻尖整形；膨体聚四氟乙烯；并发症；满意度

[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2018）10-0080-03

Abstract： Objective To investigate the application of autogenous costal cartilage graft to construct nasal tip complex in nasal tip plasty. Methods Ninety patients who underwent rhinoplasty surgery in our hospital from June 2016 to June 2017 were selected as study subjects. Paired comparison method was used to divide them into two groups， 45 cases in each group. The costal cartilage group used autogenous costal cartilage graft to construct nasal tip complex. The prosthesis group was treated with expanded polytetrafluoroethylene. The effect of surgery and the incidence of complications were compared between the two groups. Results The operative success rate of the costal cartilage group and the prosthesis group was 100.0% and 97.8% respectively， and the difference was not statistically significant（P>0.05）. There was no significant difference in healing time between the two groups after operation（P>0.05）. The prominent degree of nasal tip in the costal cartilage group was higher than that in the prosthesis group， the difference was statistically significant（P<0.05）. The patients in the costal cartilage group had higher scores of satisfaction （fullness of inferior nasal lobule， shape of nose， diameter of nostril and rotation of nasal tip） than those in the prosthesis group， and the overall satisfaction rate was 88.9%， higher than that in the prosthesis group（71.1%）， the differences were statistically significant（P<0.05）. The incidence of chronic infection and swelling in the costal cartilage was lower than those in the prosthesis group（P<0.05）. Conclusion The construction of nasal tip complex with autologous costal cartilage grafting can improve the nose tip protrusion and general satisfaction， reduce the incidence of complications such as postoperative infection and deformation， and it is worthy of popularization in rhinoplasty.

Key words： autogenous costal cartilage； nasal tip complex； nasal tip plasty； expanded polytetrafluoroethylene（e-PTFE）；

complications； satisfaction

鼻位于面部中央，鼻外形一直以来受到广大爱美者的关注。隆鼻术是通过置入各种材料以隆起或抬高鼻部形态为主要目的的鼻部整形手术，适用于鼻梁或鼻头低平者，据统计，隆鼻术是目前开展最多的整形手术之一[1]。隆鼻术的鼻头、鼻背高度材料以硅胶和膨体聚四氟乙烯最为常见，但由于排异现象、承受力差以及感染率高等缺点，临床效果不尽如人意。近年来，有学者指出，自体肋软骨取材简单、无排斥反应、支撑力强、可进行个性化雕刻，能够有效满足各种就医者的鼻部整形需求[2]。为探究不同置入材料的临床效果，本研究收集了90例隆鼻者临床资料进行分组比较，现报道如下。

1 资料和方法

1.1 一般资料：选取2016年6月-2017年6月于笔者医院行隆鼻整形的90例就医者为研究对象，采用配对比较法将其分为采取自体肋软骨移植构建鼻尖复合体整形的肋软骨组和采取膨体聚四氟乙烯鼻尖复合体的假体组，每组45例。所有……