超声动态可视化监测下鼻骨骨折闭合性复位的研究
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蚌埠医科大学第一附属医院

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安徽省高等学校科学研究重点项目(自然科学类)(编号:2022AH051501);


Closed reduction of nasal bone fractures ultrasound dynamic visualization monitoring
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Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Bengbu Medical University,Bengbu

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    摘要:

    目的 探究讨论在闭合性鼻骨骨折治疗中利用超声全程动态可视化监测的临床应用价值,深入研究在全程超声动态监测下实施手法复位治疗闭合性鼻骨骨折的实用性及实际效果。方法 本项研究选用蚌埠医科大学第一附属医院收治并加以随访的84例闭合性鼻骨骨折患者,根据随机化的基本原理将患者随机分成超声组与传统组两组。超声组采用在全程超声动态可视化监测下行手法复位的方式进行鼻骨骨折闭合性复位治疗,传统组采用传统的手法整复的方式行鼻骨骨折闭合性复位治疗。我们通过对住院总时间、术前准备完善时间、术中复位操作时间、术后CT影像评分、鼻部外形恢复情况以及自制VAS鼻通气评分的数据对比对两种整复方法的效果进行评价。 结果 超声组在满足全身麻醉状态下的42例患者,均快速地进行了精准的手法复位治疗。术中复位钳放置准确位置、鼻腔填塞物填塞妥当,术中整复操作时间短,住院总时间短,术后CT影像评分和鼻部结构及外形恢复情况以及鼻腔通气功能与传统组比较均优于传统组。结论 全程超声动态可视化监测应用于新鲜鼻骨骨折闭合性复位,术中操作时间虽较传统复位时间延长,但通过超声探头可在术中实时观察复位钳是否在位准确、在复位钳撬拨过程中骨折块是否精准复位、填塞物是否精准填塞、以及在填塞物作用下骨折块有无偏移正常位置。这一技术的应用,使得鼻骨骨折闭合性复位由原本传统的盲视下操作转变为在超声可视化下快速、精准操作,既有助于缩短患者诊疗时长,又能够提高复位准确率、术后CT评分,从而获得更高的病人满意度。这也使得临床深入总结鼻骨骨折类型以及针对不同骨折类型制定个体化诊疗方案成为可能。

    Abstract:

    Objectives To investigate and discuss the clinical application value of the whole-course ultrasound dynamic visualization monitoring in the treatment of closed nasal bone fracture, and to study the practicality and effect of manual reduction under the whole-course ultrasound dynamic monitoring in the treatment of closed nasal bone fracture. Methods Eighty-four patients with closed nasal bone fracture who were admitted to the First Affiliated Hospital of Bengbu Medical University and followed up in this study were randomly divided into the ultrasound group and the traditional group according to the basic principle of randomization. The ultrasound group was treated with closed reduction of nasal bone fracture by manual reduction under the whole-course ultrasound dynamic visualization monitoring, while the traditional group was treated with closed reduction of nasal bone fracture by traditional manual reduction. We evaluated the effects of the two methods by comparing total hospital stay, preoperative preparation time, intraoperative reduction time, postoperative CT imaging scores, nasal shape recovery, and homemade VAS nasal ventilation scores. Results The 42 patients in the ultrasound group under satisfactory general anaesthesia were treated rapidly with precise manual reduction. The intraoperative repositioning forceps were placed in the correct position, the nasal packing was properly filled, the intraoperative repositioning operation time was short, the total hospital stay was short, and the postoperative CT imaging scores, recovery of nasal structure and shape, and nasal ventilation function were better than those of the traditional group. Conclusion Ultrasound dynamic visualization monitoring throughout the entire process is applied to fresh nasal fracture closed reset. Although the intraoperative operation time is longer than that of traditional reduction, the ultrasound probe can be used to observe in real time whether the reduction forceps are accurately positioned, whether the fracture block is accurately reduced during the prying process of the reduction forceps, whether the filler is accurately filled, and the normal position of the fracture block under the action of tamponade. The application of this technology has transformed the closed reduction of nasal bone fracture from the original traditional blindness to transform to fast and accurate operations under ultrasound visualization, which not only helps to shorten the patient"s diagnosis and treatment, but also improve the accuracy of reset, postoperative CT Rating, so as to get higher patient satisfaction. This also makes it possible for clinical in -depth summary of nasal fracture type and formulating individualized diagnosis and treatment plans for different types of fractures.

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  • 收稿日期:2025-05-11
  • 最后修改日期:2025-05-26
  • 录用日期:2025-06-10
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