摘要
目的探讨自体脂肪填充联合自体肋软骨对Binder综合征短鼻畸形的矫正及效果。方法以2016年1月到2017年12月手术治疗Binder综合征患者120例作为研究对象,随机分为对照组和观察组,各60例。对照组患者采用肋软骨进行移植手术,观察组患者采用肋软骨移植术后肋软骨颗粒和自体脂肪进行混合填充。观察两组患者术前及术后1周、3个月、6个月鼻尖鼻长比、鼻唇角、鼻额角。随访至术后6个月,对两组患者满意度、术后不良反应及躯体变形障碍(BDD)情况进行比较。结果术后,两组患者较术前鼻尖鼻长比增加,鼻唇角缩小(P均<0. 01),且观察组优于对照组(P均<0. 01)。随访至术后6个月,观察组患者满意度显著高于对照组(75. 00%vs55. 00%,χ2=5. 275,P=0. 022);两组患者不良反应总发生率比较差异无统计学意义(16. 67%vs 11. 67%,χ2=0. 617,P=0. 432);观察组患者BDD发生率低于对照组(13. 33%vs 28. 33%,χ2=4. 093,P=0. 043)。结论对Binder综合征患者行自体脂肪联合肋软骨填充术可有效改善填充部位的受力支撑情况,提升整容效果和满意度,进一步缓解患者BDD等不良心理状态。
Abject: Objective To investigate the clinical effect of autologous fat filling combined with autologous costal cartilage on the correction of short-nose deformity of patients with Binder syndrome. Methods A total of 120 patients with Binder syndrome treated surgically from January 2016 to December 2017 were randomly divided into control group and observation group( n = 60,each). The costal cartilage transplantation was performed in control group,while the costal cartilage granules and autologous fat were mixed and filled after costal cartilage transplantation in observation group. The ratio of nasal tip to nasal length,nasolabial angle,nasolabial-frontal angle were observed before and 1-,3-and 6-month after operation in two groups. During 6-month postoperative follow-up,the patients' satisfaction,adverse reactions and body dysmorphic disorder( BDD) were compared between two groups. Results After operation,the ratio of nasal tip to nosal length increased,and the nasolabial angle decreased in both groups( all P < 0. 01),and they were better in observation group than those in control group( all P < 0. 01). During follow-up period,the satisfaction degree of patients in observation group was significantly higher than that in control group( 75. 00% vs 55. 00%,χ2= 5. 275,P = 0. 022). There was no significant difference in the total incidence of adverse reactions between two groups( 16. 67% vs 11. 67%,χ2= 0. 617,P = 0. 432).The incidence of BDD in observation group was statistically lower than that in control group( 13. 33% vs 28. 33%,χ2=4. 093,P = 0. 043). Conclusion Autogenous fat and costal cartilage filling can effectively improve the stress support of the filling site in the patients with blinder syndrome,increase the effect and satisfaction degree of the patients,and further reduce the mental state of the body image disorder.
引文
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