鼻中隔骨折对鼻骨骨折复位效果的影响

目的　探讨鼻中隔骨折的发生率及其对鼻骨骨折复位效果的影响。方法　回顾性分析212例鼻外伤患者的临床资料，A组112例行单纯鼻骨闭合复位术，其余患者行同期鼻中隔矫正术；B组58例术前诊断伴有鼻中隔骨折；C组42例诊断单纯鼻骨骨折，比较组间复位效果及手术前后鼻中隔骨折诊断符合程度。结果　A组术后3个月随访发现歪鼻27例（24.1%），B+C组术后3个月随访共发生歪鼻9例（9.0%）；B组58例（100%）、C组30例（71.8%）患者在术中被证实为鼻中隔骨折，CT诊断鼻中隔骨折符合率为58.0%，而实际鼻中隔骨折发生率为88.0%。结论　CT诊断鼻中隔骨折与实际发生率有明显差异，鼻骨闭合复位术同期行鼻内镜下鼻中隔偏曲矫正术能显著降低术后歪鼻发生率。

Influence of nasal septum fracture on the effect of nasal bone reduction

OBJECTIVE To investigate the incidence rate of nasal septum fracture and it's influence on the effect of nasal bone reduction. METHODS Retrospective analysis of 212 cases of nasal fracture compared with nasal septum deviation were carried out. Among these cases 112 treated with nasal bone reduction only was called group A; the other cases were treated with nasal reduction concomitantly with septoplasty. Among them 58 cases were diagnosed with nasal septum fracture, it was called group B; 42 cases were diagnosed with nasal septum deviation, it was called group C. The postoperative nasal deformity rate was assessed, and the intraoperative findings of nasal septum contrast with preoperative CT diagnosis was analysed. RESULTS Three months after the operation, 27 cases (24.1%) of nasal deformity were found in group A; 9(9.0%) cases of nasal deformity were found in group B+C; septum fracture was found in 58 cases (100%) in group B and 30(71.8%) cases in group C introperatively. The diagnosis rate of nasal septum fracture by CT was 58.0%, while it's incidence rate was 88.0%. CONCLUSION More nasal septum fractures were observed introperatively than CT findings, and septoplasty concomitantly with nasal bone reduction can obviously reduce the rate of nasal deformity.