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目的比较内镜辅助下治疗与头皮冠状切口手术在颧骨复合体骨折中的疗效及并发症。方法将2008年1月-2014年5月收治的50例颧骨复合体骨折患者完全随机分为内镜辅助下治疗组(试验组,30例)及头皮冠状切口术式组(对照组,20例)。试验组在内镜辅助下行骨折功能复位并固定骨折线;对照组行头皮内冠状切口,行骨折功能复位内固定术。根据体格检查及CT复查评估并对比两组患者的疗效,同时对手术并发症进行对比分析。结果试验组疗效Ⅰ级24例(80.0%),Ⅱ级5例(16.7%),Ⅲ级1例(3.3%);对照组疗效Ⅰ级16例(80.0%),Ⅱ级3例(15.0%),Ⅲ级1例(5.0%);两组疗效差异无统计学意义(P>0.05)。试验组无患者发生并发症,对照组发生面神经损伤4例(20.0%),脱发5例(25.0%),颞部凹陷4例(20.0%),头皮血肿5例(25.0%);对照组各并发症发生率均高于试验组,差异有统计学意义(P<0.05)。结论内镜辅助下治疗颧骨复合体骨折与传统的头皮冠状切口术式疗效确切无差异,但减少了手术的并发症,是一种微创和符合美学的手术方式。
Objective To compare the efficacy and complications of endoscopic-assisted treatment with scalp and coronal incision in zygomatic complex fractures. Methods Fifty patients with zygomatic complex fracture who were treated in our hospital from January 2008 to May 2014 were randomly divided into endoscope-assisted treatment group (experimental group, 30 cases) and scalp coronal incision group (control group, 20 example). The experimental group underwent endoscopic assisted fracture reduction and fixation of the fracture line. The control group received scalp coronary incision and fracture reduction and internal fixation. According to physical examination and CT review to evaluate and compare the efficacy of the two groups of patients, at the same time, the comparative analysis of surgical complications. Results The efficacy of the experimental group was 24 cases (80.0%) in grade Ⅰ, 5 cases (16.7%) in grade Ⅱ and 1 case (3.3%) in grade Ⅲ, 16 cases (80.0% ), Grade Ⅲ 1 case (5.0%); There was no significant difference between the two groups (P> 0.05). No complications occurred in the experimental group. Four cases (20.0%) of facial nerve injury, five cases of hair loss (25.0%), four cases of temporal depression (20.0%) and five cases of scalp hematoma (25.0%) were found in the control group. Complications were higher than the experimental group, the difference was statistically significant (P <0.05). Conclusion Endoscopic assisted treatment of zygomatic complex fractures with the traditional scalp and corneal incision effect is no difference, but reduce the complications of surgery, is a minimally invasive and aesthetic approach to surgery.