周琮镇　黄见勇　蒋永强

[摘要]目的：探究自體耳软骨联合假体行综合鼻整形术的美学效果。方法：选取2016年10月-2019年5月于笔者医院就诊的80例行综合鼻整形术患者，按照随机数字表法分为观察组（40例）、对照组（40例）。观察组采用自体耳软骨联合假体行综合鼻整形，对照组采用假体行综合鼻整形，两组均随访1年。观察并比较两组手术效果，术前、术后1年美学效果，术后1年满意度及随访期间并发症发生情况。结果：观察组愈合时间短于对照组，矫正成功率高于对照组，差异均有统计学意义（P<0.05）。两组手术时间比较差异无统计学意义（P>0.05）。术后1年，两组鼻尖长度较术前延长，观察组长于对照组;鼻尖高度较术前升高，观察组高于对照组;而鼻唇角较术前降低，观察组低于对照组，差异均有统计学意义（P<0.05）。术后1年，观察组患者对鼻尖宽、鼻尖角、后旋角、表现点、鼻背高度的满意度高于对照组，差异均有统计学意义（P<0.05）。随访期间，观察组并发症发生率为7.50%，低于对照组的25.00%，差异有统计学意义（P<0.05）。结论：自体耳软骨联合假体行综合鼻整形可提高患者对鼻部形态的满意度，并可降低并发症发生率，同时具有较好的美学效果。

[关键词]自体耳软骨;假体;综合鼻整形术;美学效果;满意度

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）09-0070-03

Effect of Comprehensive Rhinoplasty with Autologous Auricular Cartilage Combined with Prosthesis

ZHOU Cong-zhen，HUANG Jian-yong，JIANG Yong-qiang

（Santai Yue Jia Mei Medical Beauty Clinic，Mianyang 621100，Sichuan，China）

Abstract： Objective  To explore the aesthetic effect of autologous auricular cartilage combined with prosthesis in patients undergoing comprehensive rhinoplasty. Methods  Between October 2016 and May 2019， 80 patients undergoing comprehensive rhinoplasty in our hospital were divided into the observation group （40 cases） and the control group （40 cases） according to the random number table method. The observation group was treated with autologous auricular cartilage combined with prosthesis， while the control group was treated with prosthesis， both groups were followed up for one year. The surgical effects， aesthetic effects before and one year after operation， satisfaction at one year after operation， and complications at the nasal tip during follow-up were observed and compared between the two groups. Results  The healing time of the observation group was shorter than that of the control group， and the success rate of correction was higher than that of the control group， the differences were statistically significant （P<0.05）. There was no significant difference in operation time between the two groups （P>0.05）. One year after operation， the length of nasal tip in the two groups was longer than that before operation， and the observation group was longer than that in the control group （P<0.05）. The height of nasal tip in the two groups was higher than that before operation， the height of nasal tip in the observation group was higher than that in the control group （P<0.05）. The nasolabial angle in the two groups was lower than that before operation， the nasolabial angle in the observation group was lower than that in the control group （P<0.05）. One year after operation， the satisfaction of patients in the observation group with nasal tip width， nasal tip angle， posterior rotation angle， manifestation point and nasal dorsal height was higher than those in the control group （P<0.05）. During the follow-up period， the incidence of complications in the observation group was 7.50%， lower than that in the control group （25.00%， P<0.05）. Conclusion  Autologous auricular cartilage combined with prosthesis could promote postoperative healing of patients undergoing comprehensive rhinoplasty， improve patients' satisfaction with nasal morphology， reduce the incidence of complications， and with higher aesthetic effect.

Key words： autogenous auricular cartilage; prosthesis; comprehensive rhinoplasty; aesthetic effect; satisfaction

综合鼻整形术的重点及难点在于构建新的、稳定的鼻尖及鼻背支架，进而调整鼻部结构，达到较为理想的美学效果，目前综合鼻整形的方法较多，包括假体隆鼻、自体软骨隆鼻等，目前尚无统一标准[1-3]。通过假体调整鼻部形态为传统综合鼻整形方案，置入硅胶假体后可使得鼻外形挺拔，但单纯置入硅胶假体弹性较差，鼻尖张力大，外形僵硬，可能影响患者满意度。随着综合鼻整形理念及技术的发展，自体耳软骨联合假体作为填充、垫高材料的治疗方案越来越受到青睐，自体耳软骨作为人体自身材料，不仅排斥反应低，且更易于塑形，临床应用越来越多[4]。……