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在患有勒福特模式面部创伤的患者中输管方法的安全性
Christina Kuhrau1, Joseph Easton, Kiersten Woodyard De Brito
1Division of Plastic, Reconstructive and Hand/Burn Surgery, Department of Surgery, University of Cincinnati, Cincinnati, OH.
The Journal of craniofacial surgery
|July 29, 2025
概括
鼻腔内输管 (NTI) 的并发症率相当于LeFort骨折修复的气管切除术,同时避免了气管切除术.
科学领域:
- 面外科手术 面外科手术
- 创伤外科 手术 创伤外科
- 麻醉学 麻醉学
背景情况:
- 莱福特骨折的气道管理存在风险:气管切除术 (出血,感染,痕) 和鼻内输管 (潜在的内并发症).
- 在复杂的面部创伤手术中,选择最佳的呼吸道对于患者的结果至关重要.
研究的目的:
- 在接受勒福特骨折修复的成年人中,比较气管切除术,鼻内输管 (NTI) 和口内输管 (OTI) 之间的并发症率.
- 为了确定LeFort骨折的气道管理后重新干预的预测因素.
主要方法:
- 60名接受LeFort I-III骨折修复的成年患者的回顾性队列研究 (2018-2023年).
- 呼吸道方法的分析,骨底部骨折的存在,并发症和重复手术.
- 平均并发症的等价性测试和重干预预测器的多变量回归.
主要成果:
- 每名患者的平均并发症在NTI和气管切除术之间是相当的 (0.50对0.54,P=0.019),包括严重的LeFort II/III损伤 (0.45对0.56,P=0.040).
- 气管切除术是重新干预的独立预测因子 (OR2.3,P=0.025).
- 鼻腔输管证明了与气管切除术相似的并发症概况,但重复手术率较低.
结论:
- 鼻内输管提供了一种呼吸道管理策略,并发症率与勒福骨折的气管切开术相似.
- NTI避免了与气管切除术相关的重新手术风险增加和痕.
- 这表明,在特定的LeFort骨折病例中,NTI是气管切除术的可行替代方案,特别是当骨底部完整性是一个问题时.
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