首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 125 毫秒
1.
目的:探讨假体隆鼻时应用鼻中隔软骨联合耳软骨雕塑鼻尖的临床效果。方法:选取2013年1月至2014年3月在我院进行隆鼻术的患者98例,按照随机数表法将其分成对照组和实验组,每组49人。对照组患者采用单纯的假体隆鼻,实验组患者采用假体隆鼻并使用鼻中隔软骨联合耳软骨雕塑鼻尖。评价手术的满意程度及手术前后患者的鼻长、鼻尖高度、鼻尖角的变化情况。结果:实验组患者的治疗满意度为91.84%,明显高于对照组的40.82%,差异具有统计学意义(P0.05)。实验组患者术后鼻长、鼻尖高度、鼻尖角均优于手术前(P0.05),且显著优于对照组,差异均有统计学意义(P0.05)。结论:应用鼻中隔软骨联合耳软骨雕塑鼻尖在假体隆鼻中具有良好的应用效果,满意度较高,值得在临床上推广使用。  相似文献   

2.
目的:探讨鼻内镜下鼻中隔矫正术的效果及其对鼻腔鼻窦微创手术的临床意义。方法:2010年3月至2013年3月对102例伴有鼻中隔偏曲的鼻腔鼻窦疾病患者,随机分为研究组(n=78)和对照组(n=24),分别施行了鼻内镜下鼻中隔矫正术和传统手术。结果:对照组患者治愈率为64.29%、总有效率78.57%,治疗组分别为83.78%和95.95%;两组临床疗效比较,差异具有统计学意义(P0.05)。研究组患者的术中的出血量和手术时间均明显少于对照组,差异具有统计学意义(P0.05)。术后研究组患者的出血量和并发症总数均明显少于对照组,差异具有统计学意义(P0.05)。研究组患者的平均住院时间明显短于对照组,差异显著具有统计学(P0.05)。结论:鼻内镜下鼻中隔矫正术较传统鼻中隔矫正术安全,效果可靠,手术并发症少,患者恢复快,更有利于同期鼻腔鼻窦微创手术的实施,提高了其手术治疗效果。  相似文献   

3.
摘要 目的:探讨重组牛碱性成纤维细胞生长因子(bFGF)外用凝胶联合耳内镜下软骨-软骨膜修补术治疗鼓膜大穿孔的临床疗效。方法:选择2021年1月-2022年11月在中国人民解放军联勤保障部队第九八一医院接受诊治的鼓膜大穿孔患者120例。将患者根据随机数字表法分为对照组和研究组,各60例。对照组接受耳内镜下软骨-软骨膜修补术,研究组接受重组牛bFGF外用凝胶联合耳内镜下软骨-软骨膜修补术。对比两组愈合情况、听力情况[骨导听阈、气导听阈、气骨导差(A-B gap)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]和并发症发生情况。结果:研究组的愈合例数高于对照组,平均愈合天数短于对照组(P<0.05)。研究组术后6个月骨导听阈、气导听阈、A-B gap低于对照组(P<0.05)。研究组术后3dTNF-α、IL-1β、IL-6低于对照组(P<0.05)。研究组的并发症发生率低于对照组(P<0.05)。结论:重组牛bFGF外用凝胶联合耳内镜下软骨-软骨膜修补术治疗鼓膜大穿孔,可缩短鼓膜愈合时间,改善患者听力,减轻炎症反应,安全性较好。  相似文献   

4.
目的:探讨鼻中隔成形术中鼻腔填塞法及鼻中隔"8"字缝合法的疗效。方法:选取2017年7月~2018年7月期间我院收治的拟行鼻中隔成形术的鼻中隔偏曲患者60例。采用乱数表法将患者分为对照组、实验组两组,各30例患者,两组患者均行鼻内镜下鼻中隔成形术,术后对照组给予鼻腔填塞法处理,实验组给予鼻中隔"8"字缝合法处理。比较两组术后临床疗效、鼻粘膜水肿情况,观察两组不同时间点视觉疼痛模拟评分(VAS)情况,记录两组患者术后鼻中隔并发症发生情况。结果:实验组术后7d临床总有效率为96.67%(29/30),显著高于对照组患者的80.00%(24/30),差异有统计学意义(P0.05)。与术前相比,两组患者术后12hVAS评分升高,术后24h、术后48hVAS评分下降(P0.05);与术后12h相比,两组患者术后24h、术后48hVAS评分均下降,且术后48hVAS评分低于术后24h(P0.05);实验组术后12h、术后24h、术后48hVAS评分均低于对照组(P0.05)。实验组鼻粘膜水肿0级患者数量显著高于对照组,鼻粘膜水肿1级患者数量显著低于对照组(P0.05);两组鼻粘膜水肿2级患者数量比较差异无统计学意义(P0.05);两组患者鼻中隔并发症总发生率比较差异无统计学意义(P0.05)。结论:相较于鼻腔填塞法,鼻中隔成形术中采用鼻中隔"8"字缝合法疗效显著,可减轻患者疼痛,改善患者鼻粘膜水肿情况,且不会增加并发症发生率,具有一定的临床应用价值。  相似文献   

5.
刘文杰 《蛇志》2017,(3):379-382
<正>随着我国医疗技术的不断发展,鼻疾病的治疗手段也逐渐优化。鼻中隔成形术是一种临床常见的理想手术治疗方式,术后常规行鼻腔填塞。研究证明术后鼻腔填塞,虽然能起到良好固定残余鼻中隔软骨的作用,但并发症的发生风险也随之增加,鼻腔填塞后的感染、血肿等不良反应也影响了治疗效果;而且鼻腔填塞治疗的填充材料、方式等均取决于  相似文献   

6.
夏良勇 《蛇志》2016,(3):352-353
目的探讨内镜下鼻中隔偏曲矫正术的方法及策略。方法回顾性分析2014年11月~2015年11月我院就诊的鼻中隔偏曲矫正术患者122例的临床资料。结果全身麻醉的患者出血量27~89ml,平均68.54ml;手术时间为16~78min,平均37.62min。局部麻醉的患者出血量13~77ml,平均26.65ml;手术时间为7~64min,平均31.89min。全身联合局部麻醉的患者出血量25~73ml,平均42.52ml;手术时间为9~84min,平均35.89min。术后大部分患者主诉临床症状好转。结论内镜下鼻中隔偏曲矫正术要遵循鼻中隔偏曲产生的生物学规律,尽可能恢复和保留鼻腔和鼻窦正常形态和生理功能。  相似文献   

7.
目的:探讨重组人骨形成蛋白-2(rhBMP-2)作为激活物诱导异位软骨修复并重建兔气管缺损的可行性。方法:取24只新西兰大白兔,制备气管前壁软骨1/3缺损模型。随机分为A、B组,每组12只,A组为实验组,在气管缺损处前壁颈前肌肉修补,多点注射rhBMP-2;B组于气管软骨缺损部位直接颈前肌群修补。术后观察动物一般情况,于4、8、12周取材进行大体观察、HE染色观察重建区域情况。结果:术后A组动物均存活至实验完成,B组因气道感染及气道分泌物堵管潴留致使实验兔死亡,其余动物出现皮下气肿,呼吸不畅等情况。组织学观察A组有明显的新生软骨细胞及少量软骨样组织,可见结缔组织包绕,周围肌肉组织完整,排列整齐,未见明显坏死组织,有少量淋巴细胞浸润。B组未见软骨组织生成,可见大量肉芽组织增生,结缔组织排列紊乱,伴少量坏死组织,大量淋巴浸润。结论:rhBMP-2可通过注射到颈前肌肉修补肌群中诱导软骨细胞和软骨样组织生成,减轻炎症反应,联合颈前肌瓣修复重建气管缺损能充分维持修复重建后的气道形态,具有减少术后皮下气肿、气管狭窄的作用,有望用于临床修复重建气管组织缺损。  相似文献   

8.
目的:探讨耳内镜下应用瑞济生物羊膜这一新型材料进行鼓膜修补术的可行性,为临床鼓膜修补术探索新的、更为理想的修复材料提供新的思路。方法:临床筛选18例(24耳)鼓膜紧张部中央性穿孔患者,在耳内镜下进行手术,修补材料应用瑞济生物羊膜作为移植材料,全部采用内植法行鼓膜修补术。移植材料内外均有明胶海绵支撑,术后10天取出外耳道填塞物。结果:术后随访6个月,除2例(2耳)术后感染而穿孔未愈外,其余16例(22耳)全部一期愈合,鼓膜形态完好,无手术并发症发生,成功率97.1%。结论:内镜下经外耳道鼓膜成形术具有创伤小、术后恢复快、疗效好的优点。瑞济生物羊膜来自同种异体,成分单一,抗原少,免疫排斥小,可规模化、标准化生产,手术应用操作简单方便,成功率高,可作为鼓膜修补术较为理想的移植修复材料,值得临床推广应用。  相似文献   

9.
目的:探讨重组人骨形成蛋白-2(rhBMP-2)作为激活物诱导异位软骨修复并重建免气管缺损的可行性。方法:取24只新西兰大白兔,制备气管前壁软骨1/3缺损模型。随机分为A、B组,每组12只,A组为实验组,在气管缺损处前壁颈前肌肉修补,多点注射rhBMP-2;B组于气管软骨缺损部位直接颈前肌群修补。术后观察动物一般情况,于4、8、12周取材进行大体观察、HE染色观察重建区域情况。结果:术后A组动物均存活至实验完成,B组因气道感染及气道分泌物堵管潴留致使实验兔死亡,其余动物出现皮下气肿,呼吸不畅等情况。组织学观察A组有明显的新生软骨细胞及少量软骨样组织,可见结缔组织包绕,周围肌肉组织完整,排列整齐,未见明显坏死组织,有少量淋巴细胞浸润。B组未见软骨组织生成,可见大量肉芽组织增生,结缔组织排列紊乱,伴少量坏死组织,大量淋巴浸润。结论:rhBMP-2可通过注射到颈前肌肉修补肌群中诱导软骨细胞和软骨样组织生成,减轻炎症反应,联合颈前肌瓣修复重建气管缺损能充分维持修复重建后的气道形态,具有减少术后皮下气肿、气管狭窄的作用,有望用于临床修复重建气管纽织缺损。  相似文献   

10.
目的:将未诱导的自体脂肪干细胞(ADSCs)与富血小板纤维蛋白(PRF)复合,作为一种全新的软骨修复材料,探讨其对家兔耳软骨全层缺损修复的可行性.方法:取家兔10只,于每只家兔耳部做4处软骨全层缺损,随机分为A、B、C、D组,A组,作为空白对照;B组植入自体ADSCs;C组植入自体PRF;D组植入自体ADSCs与PRF的复合物.分别于术后1月、2月、3月取材,进行大体及HE染色观察,并使用IPP6.0软件对软骨生成量进行半定量分析.结果:HE染色显示,3月后,A组几乎无新生软骨生成,B、C、D三组软骨生成量依次增多,D组尤为明显.IPP6.0统计结果显示,移植物植入3月后,A组软骨缺损修复率为(1.68±0.17)%,B组为(15.4±0.91.)%,C组为(32.0±2.76)%,D组为(85.77±4.88)%.各组间有显著统计学差异,与HE染色结果相符.结论:未诱导的自体ADSC s复合自体PRF作为一种全新的软骨修复材料,可以有效的修复家兔耳软骨全层缺损,具有潜在的临床应用价值.  相似文献   

11.
We use histological techniques and computer‐aided three‐dimensional reconstructions made from serial histological sections to describe the ontogeny of the ethmoidal endocranium of discoglossid frog Discoglossus pictus. We identify a pattern of development for the suprarostral cartilage that differs from previous findings and probably represents the ancestral anuran pattern. The nasal cartilages, including the inferior prenasal cartilage, are de novo adult structures. The only larva‐derived structures of the adult nasal capsules are the posterior aspects of the solum nasi and septum nasi. We also identify patterns of development for the ethmoid plate and postnasal wall that occur during early in ontogenesis. These patterns are associated with development events during metamorphic climax. The pattern of timing of chondrification of the anterior nasal cartilages more closely coincides with that of the neobatrachian species than that recorded for the pelobatid frog Spea. In addition, this study supports a sister taxon relationship between Discoglossus and Alytes. J. Morphol. 271:1078‐1093, 2010. © 2010 Wiley‐Liss, Inc.  相似文献   

12.
The internal nasal skeleton in Monodelphis domestica, the gray short-tailed opossum, primarily supports olfactory and respiratory epithelia, the vomeronasal organ, and the nasal gland. This scaffold is built by the median mesethmoid, and the paired vomer and ethmoid bones. The mesethmoid ossifies within the nasal septum cartilage. The bilateral ethmoid segregates respiratory and olfactory regions, and its geometry offers insight into the functional, developmental, and genomic organization of the nose. It forms through partial coalescence of separate elements known as turbinals, which in Monodelphis comprise the maxilloturbinal, nasoturbinal, five endoturbinals, and two ectoturbinals. Geometry of the ethmoid increases respiratory mucosal surface area by a factor of six and olfactory mucosal surface by nearly an order of magnitude. Respiratory epithelium warms and humidifies inspired air, recovers moisture as air is exhaled, and may help mediate brain temperature. In contrast, the olfactory skeleton functions as a series of small funnels that support growth of new olfactory neurons throughout life. Olfactory mucosa lines the mouth of each funnel, forming blind olfactory recesses known as the ethmoid cells, and neuronal axons are funneled from the epithelium through tiny olfactory foramina in the cribriform plate, into close proximity with target glomeruli in the olfactory bulb of the brain where each axon makes its first synapse. The skeleton may thus mediate topological correspondence between odorant receptor areas in the nose with particular glomeruli in the olfactory bulb, enabling growth throughout life of new olfactory neurons and proper targeting by their axons. The geometric arrangement of odorant receptors suggests that a measure of volatility may be a component in the peripheral olfactory code, and that corresponding glomeruli may function in temporal signal processing. Supporting visualizations for this study are available online at www.DigiMorph.org.  相似文献   

13.
Gubisch W  Constantinescu MA 《Plastic and reconstructive surgery》1999,104(4):1131-9; discussion 1140-2
Septal deviations interfere with nasal airflow and contribute to deformities in the external appearance of the nose. An aesthetically and functionally satisfactory correction of severe septal deformities or "crippled" septal plates often requires a temporary intraoperative removal of the septal cartilage for appropriate remodeling. This article describes refinements to the previously described technique of extracorporal septoplasty; these refinements have proven useful and have made the procedure safer in the hands of less experienced surgeons. The refinements simplify the straightening methods for the explanted septal plate, achieving a stable and median fixation of the replanted septum while maintaining a satisfactory contour of the nasal dorsum. A milling cutter is used to straighten the irregularities of the explanted septal plate and to thin broadly based anterior nasal spines. When necessary, microplates are added to stabilize the osteotomized and medialized anterior nasal spine. The final positioning of the replanted septal plate is greatly enhanced by a rein stitch, transosseous sutures, and multiple quilt stitches. Additionally, direct fixation of the replanted septum to the edges of the upper lateral cartilages further improves the stability of the reconstruction. Finally, particular care should be taken to avoid residual irregularities of the nasal dorsum; it they occur, these irregularities can be covered with a thin cartilaginous splint or a layer of dehydrated fascia lata or autologous temporal fascia. A total of 436 patients who underwent rhinoseptoplasties at the authors' department during a 1-year period were reviewed. Of these patients, 108 presented with severe septal deviations and underwent an extracorporal septoplasty using the refined techniques described herein. Despite the complexity of the procedure, the patients' satisfaction rates were high, independent of the operating surgeon.  相似文献   

14.
A cribriform plate, a perpendicular plate, and two lateral masses are major components of the ethmoid bone of mammals. Notwithstanding the noticeable bone, virtually sitting in the center of the skull, extensive modifications of the skull of modern cetaceans, especially odontocetes (toothed whales), and the lack of clarity as to what characteristics delimit each element of the ethmoid has made the problem of the nature of the cetacean ethmoid more complicated and elusive than in other, less modified mammals. Furthermore, contention as to whether a perpendicular plate of the ethmoid, or the mesethmoid, exists in all mammals including cetaceans has remained unsettled. In odontocetes, the mesethmoid has been variably identified not only as the osseous nasal septum but also as the mediodorsal region of the posterior wall of the nasal passage below the nasals, as a mass of bone encased by the vomer in front of the osseous nasal cavity at the base of the rostrum, and as a combination of some portions mentioned above. The presence or absence of the mesethmoid in various groups of mammals has attracted the attention of some biologists, and here, I demonstrate that cetaceans have no mesethmoid. The close inspection of the ontogenetic changes of the basicranial elements in cetaceans reveals that a mass of bone ensheathed by the vomer in front, or at the level of the osseous nasal cavity is actually the presphenoid. It is highly likely that in odontocetes the posterior wall of the nasal passages below the nasals consists of the combination of the frontal, the imperforated cribriform plate, the paired ectethmoids, and the vomer, the latter three of which partially concealing the presphenoid dorsally and laterally as the ontogeny proceeds. In contrast, mysticetes clearly display ethmoturbinates and a cribriform plate, which are morphologically similar to those in terrestrial mammals. J. Morphol. 277:1661–1674, 2016. © 2016 Wiley Periodicals, Inc.  相似文献   

15.
The cartilaginous nasal septum plays a major role in structural integrity and growth of the face, but its internal location has made physiologic study difficult. By surgically implanting transducers in 10 miniature pigs (Sus scrofa), we recorded in vivo strains generated in the nasal septum during mastication and masseter stimulation. The goals were (1) to determine whether the cartilage should be considered as a vertical strut supporting the nasal cavity and preventing its collapse, or as a damper of stresses generated during mastication and (2) to shed light on the overall pattern of snout deformation during mastication. Strains were recorded simultaneously at the septo‐ethmoid junction and nasofrontal suture during mastication. A third location in the anterior part of the cartilage was added during masseter stimulation and manipulation. Contraction of jaw closing muscles during mastication was accompanied by anteroposterior compressive strains (around ?1,000 με) in the septo‐ethmoid junction. Both the orientation and the magnitude of the strain suggest that the septum does not act as a vertical strut but may act in absorbing loads generated during mastication. The results from masseter stimulation and manipulation further suggest that the masticatory strain pattern arises from a combination of dorsal bending and/or shearing and anteroposterior compression of the snout. J. Morphol., 2009. © 2009 Wiley‐Liss, Inc.  相似文献   

16.
Disseminated histoplasmosis in South America is associated with AIDS in 70–90 % of cases. It is visceral and cutaneous, compromising the oral, pharynx, and laryngeal mucous membranes. The involvement of the nasal mucosa is unusual. Two patients with perforation of the nasal septum as the only sign of their disease were clinically and histopathologically diagnosed as leishmaniasis. The revision of the biopsies and the culture of nasal discharge secretions showed that the pathogens seen were not amastigotes but Histoplasma capsulatum. Other mycotic lesions were not detected, nor there was history of cutaneous leishmaniasis. The leishmanin skin test, available only for the male patient, was negative. The PCR and immunofluorescence antibody titers for Leishmania were negative in both patients. They were HIV positive; in the male, his CD4+ T cell count was 60/mm3 and in the female 133/mm3. The nasal ulcer was the only manifestation of histoplasmosis and the first of AIDS in both patients. The male patient recovered with amphotericin B and itraconazole treatment. The female has improved with itraconazole. Both patients received antiretroviral treatment. Nasal mucous membrane ulcers should include histoplasmosis among the differential diagnosis. In conclusion, two patients had perforation of their nasal septum as the only manifestation of histoplasmosis, a diagnosis confirmed by nasal mucosa biopsy and by culture of H. capsulatum, findings which demonstrated that both patients had AIDS.  相似文献   

17.
Repairing defects of the lower eyelid with a free chondromucosal graft.   总被引:4,自引:0,他引:4  
A method is presented for the repair of full-thickness defects of the eyelid. The lining and tarsal plate are replaced by a free chondromucosal graft from the nasal septum, in which the cartilage is thinned and perforated. Cover is provided by a compound, bipedicled flap of skin and muscle from the opposite lid.  相似文献   

18.
目的:探讨中耳炎一期鼓室成形术后听力重建效果及影响因素。方法:2008年6月至2019年9月在本院耳鼻咽喉科进行手术治疗的中耳炎患者70例,所有患者都给予乳突切除和鼓室成形术,其中行上鼓室切开+鼓室成形术3例,行完桥式乳突切除+鼓室成形术2例,行完壁式乳突切除+鼓室成形术25例,行开放式乳突切除+鼓室成形术40例;行Ⅰ型鼓室成形术24例,行Ⅱ型鼓室成形术42例,行Ⅲ型鼓室成形术4例;用颞肌筋膜修补鼓膜的29例,用耳屏软骨-软骨膜复合体41例。计算术前和术后气骨导间距(air-bone gap),即500 Hz、1 KHz、2 KHz和4 KHz 4个频率气导均值与骨导均值的差,术后气骨导间距不大于20 dB为有效,归于有效组,大于20 dB为无效,归于无效组。结果:有效例数为42例,无效例数为28例,有效率为60%。将术前和术后气骨导间距进行配对t检验和直线相关分析,两者有显著性差异(P0.05)和显著性相关(P0.05)。将术后听力效果(即有效和无效)作为因变量,以病人性别、病人年龄、病程、随访间隔、中耳炎种类、手术类型、鼓室成形类型和修补材料作为自变量,行Logisitic回归分析,未能发现对术后听力效果有影响的因素(P0.05)。结论:大多数患者受益于一期听力重建,部分患者听力重建效果不佳,其成因有待于进一步研究。  相似文献   

19.
摘要 目的:探讨内镜下黏膜切除术治疗胃息肉的疗效及对血清胃泌素释放肽前体(ProGRP)、胃蛋白酶原I(PGI)水平的影响。方法:选取我院2019年8月到2022年8月收治的120例胃息肉患者作为研究对象,依照手术方式的不同进行分组,其中将选择常规内镜下电凝切除术治疗的60例患者分为对照组,选择内镜下黏膜切除术治疗的60例患者分为观察组。对比两组患者不良反应发生情况与治疗费用,手术前与手术后血清ProGRP、PGI表达水平以及炎症因子表达水平,对比两组患者整体切除率和并发症发生情况。结果:两组患者总治疗费用对比无差异(P>0.05),观察组患者术后不良反应发生率较对照组低(P<0.05);两组患者手术前血清ProGRP、PGI水平对比无差异(P>0.05),治疗后两组患者均降低,且观察组较对照组低(P<0.05);两组患者手术前PCT、CRP、IL-6、IL-2对比无明显差异(P>0.05),手术后两组患者PCT、CRP、IL-6、IL-2均升高,且观察组低于对照组(P<0.05);两组患者胃息肉均被完整切除,整体切除率对比无差异;且观察组穿孔、迟发性出血以及感染等并发症发生率虽低于对照组,但比较无差异(P>0.05)。结论:对胃息肉患者采取内镜下黏膜切除术与常规内镜下电凝切除术均能够完整的切除胃息肉,且治疗费用相当。而应用内镜下黏膜切除术能够降低患者ProGRP、PGI水平,降低机体炎症因子反应,且并发症发生率较低,值得临床应用推广。  相似文献   

20.
目的:探讨功能性鼻内窥镜手术治疗鼻窦炎与鼻息肉的疗效。方法:选取350例鼻窦炎与鼻息肉患者,按随机数字表法分为两组,对照组(164例)给予综合疗法,观察组(186例)给予功能性鼻内窥镜手术联合综合疗法。通过观察并记录疗效,治疗前,治疗后3个月患者体内IL-1,IL-8水平,SF-36量表评分,评价功能性鼻内窥镜手术治疗鼻窦炎与鼻息肉的疗效。结果:经手术和药物治疗,观察组有效率明显高于对照组(P0.05),治疗前,两组IL-1和IL-8水平无统计学差异(P0.05),治疗后3个月,两组IL-1和IL-8水平均明显下降,且观察组IL-1和IL-8水平低于对照组(P0.05),治疗前,两组SF-36各项评分无统计学差异,治疗后3个月,两组SF-36评分均明显增加(P0.05)。观察组在躯体疼痛和总体健康2项评分明显高于对照组(P0.05),其余6项评分相比无统计学差异(P0.05)。结论:功能性鼻内窥镜手术对鼻窦炎与鼻息肉具有较好的疗效,能显著减轻炎症反应,改善患者生活质量,值得临床推广使用。  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号