头皮冠状切口加口内切口坚固内固定治疗面中份多发性骨折的效果观察(1)
[摘要] 目的 探讨头皮冠状切口加口内切口坚固内固定治疗面中份多发性骨折的临床效果。 方法 选取本院收治的面中份多发性骨折患者30例作为研究对象，根据治疗方式分为对照组和观察组，各15例。对照组采用单纯口内切口治疗，观察组采用头皮冠状切口加口内切口，对比两组的治疗效果和不良反应。 结果 观察组的优良率为93.3%，高于对照组的66.7%，且其不良反应发生率为13.3%，低于对照组的46.7%，差异均有统计学意义(P<0.05)。 结论 头皮冠状切口加口内切口坚固内固定治疗面中份多发性骨折具有显著的效果，可减少不良反应的发生。
[关键词] 头皮冠状切口加口内切口；坚固内固定；面中份多发性骨折
[中图分类号] R782.4 [文献标识码] A [文章编号] 1674-4721(2015)02(b)-0025-03
Effect observation of scalp coronal incision combined with intraoral incision and rigid internal fixation in the treatment of midface multiple fracture
ZHU Qing-tao
Department of Stomatology，Central People′s Hospital of Huizhou City in Guangdong Province，Huizhou 516001，China
[Abstract] Objective To investigate clinical effect of scalp coronal incision combined with intraoral incision and rigid internal fixation in the treatment of midface multiple fracture. Methods 30 patients with midface multiple fracture in our hospital were selected as research objects and divided into control group and observation group according to the treatment method，each group of 15 cases.Simple oral incision treatment was used in control group，scalp coronal incision combined with intraoral incision and rigid internal fixation were applied in observation group.Treatment effect and adverse reaction in two groups were compared. Results Excellent rate of observation group was 93.3%，higher than that of control group(66.7%)，with statistical difference(P<0.05).Incidence rate of adverse reaction in observation group was 13.3%，lower than that in control group(46.7%)，with statistical difference(P<0.05). Conclusion Scalp coronal incision combined with intraoral incision and rigid internal fixation in the treatment of midface multiple fracture has significant effect，can reduce the incidence of adverse reaction.
[Key words] Scalp coronal incision combined with intraoral incision；Rigid internal fixation；Midface multiple fracture
在交通意外或其他意外事故造成的骨折中，由于颌面部生理构造的特殊性，一旦发生面中份多发性骨折，就会对人体造成很大影响，不仅影响其颌面部的外观和功能，而且会给其留下沉重的心理阴影，增加治疗难度[1-2]。本文主要探讨头皮冠状切口加口内切口坚固内固定方式治疗面中份多发性骨折的临床效果。
1 资料与方法
1.1 一般资料
随机选取本院2009年1月～2013年1月收治的面中份多发性骨折患者30例为研究对象，所有患者均采用微型钛板进行内固定处理，然后根据入路方式将其分为对照组和观察组。对照组15例，其中男12例，女3例；年龄为28～59岁，平均为(45.2±3.8)岁；骨折部位：3例为双侧上颌骨骨折，7例为颧弓合上颌骨骨折，3例为上颌骨合并下颌骨骨折，2例为上颌骨合并鼻骨骨折。观察组15例，其中男11例，女4例；年龄为27～56岁，平均为(43.2±3.4)岁；骨折部位：2例为双侧上颌骨骨折，9例为颧弓合上颌骨骨折，2例为上颌骨合并下颌骨骨折，2例为上颌骨合并鼻骨骨折。两组的性别、年龄和骨折部位等比较，差异无统计学意义(P>0.05)，具有可比性。
1.2 治疗方法
对照组采用单纯口内切口治疗，沿上颌前庭沟切开，使骨折处充分暴露，清除干净骨折断端后精确复位骨折，再使用微型钛板进行固定。观察组则采用头皮冠状切口加口内切口的方式治疗，具体措施为术前剃掉患者头发，在耳屏前距发际4 cm处行左右开口，并于切口前在其周围注射利多卡因[3]；当切口达到帽状腱膜下疏松组织层面之后需要先翻开头皮瓣，找到对应神经后切开骨膜，游离眶上神经血管束；在颧弓的上缘部位将颞深筋膜浅层切开后，按照颧弓上缘、颧弓、眶上缘、眶外缘和颧突的顺序逐一进行分离，充分暴露骨折端[4]。所有患者均采用微型钛板进行固定，术后设置引流。 (朱庆涛)
[关键词] 头皮冠状切口加口内切口；坚固内固定；面中份多发性骨折
[中图分类号] R782.4 [文献标识码] A [文章编号] 1674-4721(2015)02(b)-0025-03
Effect observation of scalp coronal incision combined with intraoral incision and rigid internal fixation in the treatment of midface multiple fracture
ZHU Qing-tao
Department of Stomatology，Central People′s Hospital of Huizhou City in Guangdong Province，Huizhou 516001，China
[Abstract] Objective To investigate clinical effect of scalp coronal incision combined with intraoral incision and rigid internal fixation in the treatment of midface multiple fracture. Methods 30 patients with midface multiple fracture in our hospital were selected as research objects and divided into control group and observation group according to the treatment method，each group of 15 cases.Simple oral incision treatment was used in control group，scalp coronal incision combined with intraoral incision and rigid internal fixation were applied in observation group.Treatment effect and adverse reaction in two groups were compared. Results Excellent rate of observation group was 93.3%，higher than that of control group(66.7%)，with statistical difference(P<0.05).Incidence rate of adverse reaction in observation group was 13.3%，lower than that in control group(46.7%)，with statistical difference(P<0.05). Conclusion Scalp coronal incision combined with intraoral incision and rigid internal fixation in the treatment of midface multiple fracture has significant effect，can reduce the incidence of adverse reaction.
[Key words] Scalp coronal incision combined with intraoral incision；Rigid internal fixation；Midface multiple fracture
在交通意外或其他意外事故造成的骨折中，由于颌面部生理构造的特殊性，一旦发生面中份多发性骨折，就会对人体造成很大影响，不仅影响其颌面部的外观和功能，而且会给其留下沉重的心理阴影，增加治疗难度[1-2]。本文主要探讨头皮冠状切口加口内切口坚固内固定方式治疗面中份多发性骨折的临床效果。
1 资料与方法
1.1 一般资料
随机选取本院2009年1月～2013年1月收治的面中份多发性骨折患者30例为研究对象，所有患者均采用微型钛板进行内固定处理，然后根据入路方式将其分为对照组和观察组。对照组15例，其中男12例，女3例；年龄为28～59岁，平均为(45.2±3.8)岁；骨折部位：3例为双侧上颌骨骨折，7例为颧弓合上颌骨骨折，3例为上颌骨合并下颌骨骨折，2例为上颌骨合并鼻骨骨折。观察组15例，其中男11例，女4例；年龄为27～56岁，平均为(43.2±3.4)岁；骨折部位：2例为双侧上颌骨骨折，9例为颧弓合上颌骨骨折，2例为上颌骨合并下颌骨骨折，2例为上颌骨合并鼻骨骨折。两组的性别、年龄和骨折部位等比较，差异无统计学意义(P>0.05)，具有可比性。
1.2 治疗方法
对照组采用单纯口内切口治疗，沿上颌前庭沟切开，使骨折处充分暴露，清除干净骨折断端后精确复位骨折，再使用微型钛板进行固定。观察组则采用头皮冠状切口加口内切口的方式治疗，具体措施为术前剃掉患者头发，在耳屏前距发际4 cm处行左右开口，并于切口前在其周围注射利多卡因[3]；当切口达到帽状腱膜下疏松组织层面之后需要先翻开头皮瓣，找到对应神经后切开骨膜，游离眶上神经血管束；在颧弓的上缘部位将颞深筋膜浅层切开后，按照颧弓上缘、颧弓、眶上缘、眶外缘和颧突的顺序逐一进行分离，充分暴露骨折端[4]。所有患者均采用微型钛板进行固定，术后设置引流。 (朱庆涛)