| 摘要: |
| 【摘要】 目的 评估超声全程动态监测在儿童鼻骨骨折治疗中的应用价值,分析超声全程动态监测引导治疗儿童鼻骨骨折的可行性及效果。方法 回顾性分析2017年4月至2018年12月，将我科室接诊48例儿童鼻骨骨折患者。男33例，女15例；年龄3～12岁，平均年龄6.5岁；18例为撞伤，12例为压砸伤，11例为打伤，7例为交通伤。其中II型22例，III型16例，IV型10例。手法整复实施时间时间为距受伤20～81 h，平均43.5h。均采用术前超声及CT检查,术中超声全程动态监测复位器位置、骨折复位及鼻腔填塞情况,记录手法整复实施时间、二次手法整复率、CT扫描次数、CT评分、鼻通气评分等。结果 48例病人中，所有患者均在满足全身麻醉条件下立即行手法整复治疗，平均术前时间22±6小时平均住院天数为4.52±1.6天，二次调整率为0，CT扫描次数为平均2次。术前术后CT评分及鼻通气评分均有显著差异。结论 超声全程动态监测下儿童鼻骨骨折闭合复位,能提前手法整复时间，透过超声探头全程监测复位器与骨折块位置情况、复位器撬拨作用下骨折端移动情况、填塞物填塞情况、填塞物作用下骨折块移动情况,使鼻骨骨折闭合性复位由盲视变为可视，缩短治疗时间，提高复位准确率，使临床深入总结儿童鼻骨骨折特点及复位方法成为可能。 |
| 关键词: 超声 动态监测 鼻骨骨折 儿童 手法复位 可视化 |
| DOI： |
| 投稿时间：2019-05-23修订日期：2020-01-17 |
| 基金项目:超声引导下鼻骨骨折闭合性复位的临床研究 |
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| Clinical Study on Visual Manual Reduction of Nasal Bone Fracture in Children under Whole-course Dynamic Monitoring of Ultrasound |
| MALI,Shen Suhong |
| () |
| Abstract: |
| 【Abstract】 Objective To evaluate the application value of whole-course dynamic monitoring of ultrasound in the treatment of nasal bone fracture in children, and to analyze the feasibility and effect of whole-course dynamic monitoring and guidance of ultrasound in the treatment of nasal bone fracture in children.Method A retrospective analysis was made of 48 children with nasal bone fracture treated in our department from April 2017 to December 2018. There were 33 males and 15 females, aged from 3 to 12 years, with an average age of 6.5 years. There were 18 bruises, 12 crush injuries, 11 bruises and 7 traffic injuries. Among them, 22 cases were type II, 16 cases were type III and 10 cases were type IV. The time of manipulative reduction was 20-81 hours from injury, with an average of 43.5 hours. Ultrasound and CT examination were used before operation. Ultrasound dynamically monitored the position of reductor, reduction of fracture and nasal packing during operation, recorded the implementation time of manual reduction, secondary manual reduction rate, number of CT scans, CT score, nasal ventilation score, etc. Result Among the 48 patients, all patients were treated with manual reduction immediately under general anesthesia. The average preoperative time was 22 + 6 hours, the average hospitalization time was 4.52 + 1.6 days, the secondary adjustment rate was 0, and the average number of CT scans was 2 times. There were significant differences in CT scores and nasal ventilation scores before and after operation.Conclusion Closed reduction of nasal bone fracture in children under whole-course dynamic monitoring by ultrasound can advance the time of manual reduction, monitor the position of reduction device and fragment, the movement of fractured end under the prying action of reduction device, the filling situation and the movement of fractured fragment under the action of filling material, so that closed reduction of nasal bone fracture can be changed from blindness to visualization, shorten the treatment time and improve the treatment efficiency. The accuracy of reduction makes it possible to summarize the characteristics and reduction methods of nasal bone fracture in children. |
| Key words: Ultrasound Dynamic monitoring Nasal bone fracture Children Manual reduction Visualization |
