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鼻骨骨折的精细化治疗:329例患者的6年研究

Refinement treatment of nasal bone fracture: A 6-year study of 329 patients.

作者信息

Chou Chieh, Chen Chao-Wen, Wu Yi-Chia, Chen Ko-Kang, Lee Su-Shin

机构信息

Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Division of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

出版信息

Asian J Surg. 2015 Oct;38(4):191-8. doi: 10.1016/j.asjsur.2014.09.002. Epub 2014 Nov 6.

Abstract

BACKGROUND

The reliability of X-ray radiography for diagnosing nasal bone fractures (NBFs) remains controversial. Recent studies show that, for determining the orientation and location of the displaced/depressed fracture, nasal sonography is as accurate as facial computed tomography. This retrospective study compared conductor-assisted nasal sonography (CANS) to conventional diagnostic tools and reported subjective patient satisfaction and discomfort after closed reduction combined with tube technique.

METHODS

This retrospective study reports the results of 329 refinement treatments for nasal bone fracture (including 199 men and 130 women) performed from 2005 to 2011. All patients were assessed with CANS and completed a survey immediately prior to removing the packing. Questionnaires were adapted from the nasal obstruction symptom evaluation (NOSE) scale.

RESULTS

The study found that CANS has a 97.2% rate of accuracy in diagnosing NBF. The visual analog scale scores of nasal obstruction, nasal congestion, sleep disturbance, trouble breathing, and inability to move air through the nose were analyzed. The experimental group scores were significantly different from the control group for all scores (p < 0.001).

CONCLUSION

Compared to conventional methods, CANS is more accurate for detecting NBF. We recommend its use as an alternative tool for diagnosing a nasal fracture. Because the tube technique balances pressure between the nasopharynx and middle ear during swallowing, patient comfort is enhanced. Application of these modifications can improve accuracy in diagnosing NBF and can improve the quality of NBF treatment.

摘要

背景

X线摄影诊断鼻骨骨折(NBF)的可靠性仍存在争议。最近的研究表明,在确定移位/凹陷性骨折的方向和位置方面,鼻超声检查与面部计算机断层扫描一样准确。这项回顾性研究将导管辅助鼻超声检查(CANS)与传统诊断工具进行了比较,并报告了闭合复位联合导管技术后患者的主观满意度和不适感。

方法

这项回顾性研究报告了2005年至2011年期间对329例鼻骨骨折进行的精细治疗结果(包括199名男性和130名女性)。所有患者均接受CANS评估,并在取出填塞物前立即完成一项调查。问卷改编自鼻阻塞症状评估(NOSE)量表。

结果

研究发现,CANS诊断NBF的准确率为97.2%。分析了鼻阻塞、鼻充血、睡眠障碍、呼吸困难和无法通过鼻子通气的视觉模拟量表评分。所有评分的实验组得分与对照组均有显著差异(p < 0.001)。

结论

与传统方法相比,CANS检测NBF更准确。我们建议将其用作诊断鼻骨折的替代工具。由于导管技术在吞咽过程中平衡了鼻咽和中耳之间的压力,因此提高了患者的舒适度。应用这些改进措施可以提高NBF诊断的准确性,并可以提高NBF治疗的质量。

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