【摘要】 目的:探究不同入路手术方式对颧骨复合体(Zygomatic complex fracture,ZMC)骨折患者术后的疗效影响。方法:选取2016年2月-2018年10月笔者医院收治的ZMC骨折患者87例,随机分为观察组(n=44)与对照组(n=43)。观察组:给予局部入路复位固定术;对照组:给予头皮冠状切口入路复位固定术。观察两组患者术前、术后1d及术后3d的VAS评分、术中出血量及手术时间,术后1周一次性骨折复位成功率,术后3个月手术满意度。结果:术后1d、术后3d观察组患者VAS评分明显低于对照组(P<0.05);术后1d及术后3d两组患者VAS评分均低于本组术前(P<0.05)。观察组术中出血量显著低于对照组,手术时间短于对照组(P<0.05);术后1周观察组患者一次手术复位成功率97.73%,明显高于对照组的81.40%(P<0.05)。术后3个月对照组患者手术满意率53.49%,低于观察组的72.73%(P<0.05)。结论:头皮冠状入路与局部入路均能治疗ZMC骨折。头皮冠状切口入路法术后骨折复位效果更好,但是创伤大,术后恢复慢;局部入路法简单、安全、快捷,且适用于对头面部美观要求较高及长时间手术耐受性差的ZMC骨折患者,可在临床广泛应用。更多还原

【Abstract】 Objective To investigate the clinical effects of different surgical methods on zygomatic maxillary complex(ZMC). Methods 87 patients with ZMC admitted to our hospital from February 2016 to October 2018 were selected, and randomly divided into two groups. The control group(n =43) was treated with reduction and fixation via coronal incision, while the observation group(n =44) was treated with local reduction and fixation via local incision. VAS score, intraoperative blood loss and operation time, one-time reduction success rate, and operation satisfaction were observed. Results VAS score showed no difference between the two groups before operation, which were decreased in both groups at the postoperative 1d and3 d(P <0.05), and were lower in the observation group than in the control group(P <0.05). The amount of intraoperative blood loss in the observation group was significantly lower than that in the control group, and the operation time was shorter than that in the control group(P<0.05). The success rate of one-time reduction in the observation group was significantly higher than that in the control group at the postoperative 1 week(97.73% vs.81.40%, P<0.05). The operation satisfaction rate of the control group was lower than that of the observation group(53.49% vs 72.73%, P<0.05). Conclusion Coronal approach and local approach can treat ZMC fracture. Coronal scalp incision approach has a better effect on fracture reduction, but it is traumatic and slow to recover. Local approach is simple, safe and fast, and suitable for ZMC fracture patients with high aesthetic requirements and poor tolerance to long-term operation. It can be widely used in clinic.更多还原