Vilela Fernando, Granjeiro Ronaldo, Maurício Carlos, Andrade Patrícia
Department of Otorhinolaryngology, Hospital de Base Brasília, Distrito Federal, Brazil.
Int Arch Otorhinolaryngol. 2014 Jul;18(3):266-71. doi: 10.1055/s-0034-1368138. Epub 2014 Mar 13.
Introduction A significant portion of patients treated in emergency departments have nasal fracture. It is important that the otolaryngologist know how to treat such damage. Objectives To evaluate the effectiveness of nasal fracture reduction under local anesthesia and tolerance to the procedure. Methods Twenty-four patients treated in the emergency department with closed reduction under local anesthesia were prospectively followed. Epidemiologic information and data regarding pain and complications during the management were noted. The degree of satisfaction was researched by visual analog scale. Results The majority of patients were male (75%), and the most common cause of injury was motor vehicle accident. We found a significant association between time to reduction and referred pain during the procedure. In patients in whom the procedure was delayed (over 3 days), there was less pain, and those who bled during the procedure had a shorter average time to reduction than the group of patients who did not bleed. Most patients were very satisfied, with more than 95% of these willing to undergo the same process again, if necessary. Conclusions The closed approach in the clinic under local anesthesia was effective and safe in restoration of the nose.
在急诊科接受治疗的患者中有很大一部分存在鼻骨骨折。耳鼻喉科医生了解如何治疗此类损伤非常重要。
评估局部麻醉下鼻骨骨折复位的有效性及患者对该手术的耐受性。
对24例在急诊科接受局部麻醉下闭合复位治疗的患者进行前瞻性随访。记录流行病学信息以及治疗过程中有关疼痛和并发症的数据。通过视觉模拟量表研究满意度。
大多数患者为男性(75%),最常见的受伤原因是机动车事故。我们发现复位时间与手术过程中的牵涉痛之间存在显著关联。在手术延迟(超过三天)的患者中,疼痛较轻,且手术中出血的患者复位平均时间比未出血的患者组更短。大多数患者非常满意,超过95%的患者表示如有必要愿意再次接受相同的治疗过程。
临床局部麻醉下的闭合复位方法在鼻骨修复中有效且安全。