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在鼻整形术中联合外侧截骨术使用类固醇以减轻术后水肿

Use Of Steroids In Rhinoplasty With Lateral Osteotomies For Reducing Post Operative Oedema.

作者信息

Sanober Aamna, Rashid Mamoon, Khan Mohammad Ibrahim, Rehman Saad Ur, Yousaf Shumaila, Rehman Orakzai Ishtiaq Ur, Fatima Samia, Eitezaz Farhan Ahmed, Hussain Adeela

机构信息

Department of Plastic Surgery, Shifa International Hospital Islamabad, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2018 Jan-Mar;30(1):45-48.

Abstract

BACKGROUND

TPostoperative periorbital oedema is a commonly encountered side effect of rhinoplasties in which lateral osteotomies have been incorporated. It dissatisfies the surgeon as well as the patient. Osteotomies are done at the end of all soft tissue manipulation to reduce the development of oedema. The aim of this study was to determine the efficacy of intravenous dexamethasone in reducing oedema in patients who undergo rhinoplasty with lateral osteotomies.

METHODS

A Prospective randomized controlled trial was done at department of plastic and reconstructive surgery, Shifa International Hospital Islamabad. Sixty patients age between 16-55 requiring open rhinoplasty were taken for this study and divided in two groups. One group received dexamethasone 8mg intravenously preoperatively and second dose 4 hours postoperatively. The second group did not receive anything. Both groups were assessed on first post-operative day and 7th day for periorbital oedema.

RESULTS

The overall decrease in oedema in patients who received steroid was by 50% while in control group was 33.3%. By the 7th day control group 13.3% patients had grade III oedema as compared to 3.33% in steroid group. Chi test was applied and p-value of 0.0289 was obtained which was found to be statistically very significant.

CONCLUSIONS

Dexamethasone used in minimal dosage showed significant advantage in reducing periorbital oedema after rhinoplasty with no evidence of any side effects secondary to steroid administration.

摘要

背景

术后眶周水肿是包含外侧截骨术的隆鼻手术常见的副作用,这让外科医生和患者都不满意。截骨术在所有软组织操作结束时进行,以减少水肿的发生。本研究的目的是确定静脉注射地塞米松对接受外侧截骨隆鼻手术患者减轻水肿的疗效。

方法

在伊斯兰堡希法国际医院整形与重建外科进行了一项前瞻性随机对照试验。本研究选取了60例年龄在16 - 55岁之间需要进行开放式隆鼻手术的患者,并将其分为两组。一组在术前静脉注射8毫克地塞米松,术后4小时注射第二剂。第二组未接受任何治疗。两组均在术后第一天和第七天评估眶周水肿情况。

结果

接受类固醇治疗的患者水肿总体减轻了50%,而对照组为33.3%。到第7天,对照组13.3%的患者出现III级水肿,而类固醇组为3.33%。应用卡方检验,得到的p值为0.0289,发现具有统计学意义。

结论

小剂量使用地塞米松在减轻隆鼻术后眶周水肿方面显示出显著优势,且没有证据表明类固醇给药会产生任何副作用。

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