[摘要]目的：探討负压引流对鼻综合整形术患者疼痛、肿胀及情绪的影响。方法：选取2017年2月-2018年2月进行鼻综合整形术的患者共48例，随机分为试验组和对照组，各24例。对照组采用常规引流条引流;试验组采用负压引流装置引流，比较两组患者疼痛、肿胀、引流效果、情绪和满意度情况。结果：术后5d，两组患者的视觉模拟评分法（Visual analogue scale，VAS）的肿胀评分和疼痛评分均较术后1d降低，且试验组明显低于对照组，差异有统计学意义（P<0.05）。术后7d，试验组患者的切口甲级愈合率高于对照组，皮下积液、积血率低于对照组，差异有统计学意义（P<0.05）。出院时，试验组患者焦虑自评量表（Self-rating anxiety scale，SAS）和抑郁自评量表（Self-rating depression scale，SDS）评分均低于对照组，满意度评分高于对照组，差异有统计学意义（P<0.05）。结论：对鼻综合整形患者术后采用负压引流装置能有效减轻颜面部肿胀和疼痛，促进伤口愈合，减少不良反应发生，改善患者的心理状况，值得临床推广和应用。

[关键词]负压引流;鼻综合整形术;疼痛;肿胀;满意度;焦虑;抑郁

[中图分类号]R473    [文献标志码]B    [文章编号]1008-6455（2020）08-0160-03

Effect of Negative Pressure Drainage on Postoperative Swelling Pain and Emotion of Patients with Comprehensive Rhinoplasty

ZHANG Rong

（C3 Ward，Plastic Surgery Hospital，Chinese Academy of Medical Sciences and Peking Union Medical College，Beijing 100144，China）

Abstract： Objective  To evaluated the the pain， swelling and mood situation in patients with comprehensive rhinoplasty using negative pressure drainage. Methods  48 patients with comprehensive rhinoplasty in our hospital between February 2017 and February 2018 were selected and randomly divided into the control group and the experimental group， with 24 cases in each group. The control group was used drainage strip only. The experimental group was used negative pressure drainage. The pain， swelling and mood situation， drainage effect and satisfaction were compared between the two groups. Results  At 5 days after surgery， the swelling score and pain score of the two groups were lower than that of 1 day after operation， and the experimental group was significantly lower than those of the control group， the differences were statistically significant（P<0.05）. 7 days after surgery， the rate of class-A healing in the experimental group was higher than that of the control group and the subcutaneous effusion rate was lower than that of the control group （P<0.05）. The scores of SAS and SDS in the experimental group were lower than those of the control group （P<0.05）. And the score of satisfaction was higher than that of the control group （P<0.05）. Conclusion  Negative pressure drainage can alleviate swelling and pain of face in the patients with comprehensive rhinoplasty， reduce adverse reactions and improve psychological condition， which is worthy for clinical promotion and application.

Key words： negative pressure drainage; comprehensive rhinoplasty; pain; swelling; satisfaction; anxiety; depression

鼻综合整形术是通过置入不同材料的假体改变鼻部的高度、形态的手术，包括隆鼻术、鼻头缩小、鼻翼缩小等9项内容。鼻部毛细血管丰富且组织疏松，进行鼻综合整形术后，常由于创面渗血、渗液出现颜面部肿胀和瘀血[1]，导致患者的工作和生活受到严重影响，加重患者对于整形美容类手术的焦虑、恐惧心理，故对术区进行术后引流至关重要。常用的常规引流条引流效果尚可，但其具有容易感染、无法直接观察引流液，且引流液排出时易污染清洁敷料导致创面细菌增生等缺点[2]，故探寻清洁度更高的引流装置势在必行。有研究表示[3]，负压引流对常规手术术后进行渗血渗液引流的优势明显，目前临床上将负压引流装置应用于鼻综合整形术的研究较少。本研究以肿胀、疼痛情况、引流效果和患者情绪变化作为重点关注指标，探究负压引流装置针对鼻综合整形患者的疗效，现报道如下。……