超声监测儿童鼻骨骨折可视化复位的应用研究

目的探讨超声全程动态监测在儿童鼻骨骨折复位治疗中的应用价值。方法选取我院收治的鼻骨骨折患儿48例,术前均行超声及CT检查,术中超声全程动态监测复位器位置、骨折复位及鼻腔填塞情况,记录手法整复实施时间、二次手法整复率、CT扫描次数、CT评分、鼻通气评分等。结果48例患儿均在全身麻醉下行手法整复治疗,平均术前时间(22±6)h,手法整复实施时间(22±6)h,均未进行二次手法调整,CT扫描次数平均2次/人,平均住院时间(4.5±1.6)d。术前CT评分2分以下者48例,术后CT评分2分以上者47例;鼻通气评分术前5分以上者9例,术后5分以上者47例,差异均有统计学意义(均P<0.05)。结论超声全程动态监测下行儿童鼻骨骨折闭合复位,可快速、准确地协助临床更安全地完成诊治工作。

Clinical study on visual reduction of nasal bone fracture in children under ultrasound monitoring

Objective To evaluate the application value of whole-course dynamic monitoring of ultrasound in thetreatment of nasal bone fracture in children.MethodsForty-eight children with nasal bone fracture were selected.Ultrasound and CT examination were used before operation.Ultrasound were performed to monitor dynamically the position of pesetter,reduction of fracture and nasal packing during operation,the implementation time of manual reduction,secondary manualreduction rate,number of CT scans,CT score,nasal ventilation score,etc.,were recorded.ResultsForty-eight cases were alltreated with manual reduction under general anesthesia,the average preoperative time was(22±6)h,the average hospitalizationtime was(4.5±1.6)d,and no secondary manual adjustment was performed.The average number of CT scans was 2 times perperson.48 cases had preoperative CT score of less than 2 points,47 cases had postoperative CT score of more than 2 points,9 cases had preoperative nasal ventilation score of more than 5 points,47 cases had postoperative CT score of more than 5 points,the differences were statistically significant(both P<0.05).Conclusion Closed reduction of nasal bone fracture in childrenunder whole-course dynamic monitoring by ultrasound can shorten the time of manual reduction,improve the treatmentefficiency,and help clinically complete diagnosis and treatment.