再造耳廓生长情况临床探究.docVIP

再造耳廓生长情况临床探究[摘要]目的：通过对再造耳廓生长情况的回顾和随访，为临床选择合适的手术年龄、合适大小的耳廓提供理论依据。方法：在整形外科医院9年间入院的患者中，选取应用皮瓣扩张、自体肋软骨支架移植方法行耳再造的、单侧、Ⅲ度、术后时间在2.5年以上的小耳畸形患者,共107例。调查内容包括：①患者的基本情况；②描出并使用微电子面积测量仪测出每组原正常耳廓、现再造耳廓及现正常耳廓样本的面积。并计算每组样本之间的面积比，对其面积变化幅度进行分析。使用Stata统计软件，用配对t检验方法来检验平均面积之间的差异的统计学意义。结果：有66例原始病例保存完整。年龄平均11.0岁(11.0±6.2岁)。随访时间：平均(3.0±0.7)年。66例患者中，与原正常耳廓相比，现再造耳廓平均增长4.4cm2；现正常耳廓平均增长2.01cm2。有89.4%的患者现再造耳廓的面积大于等于原正常耳廓面积。有81.8%的患者现正常耳廓的面积大于等于原正常耳廓面积。差异均有显著统计学意义。在小于13岁患者中，与原正常耳廓相比，现再造耳廓平均增长4.67cm2；现正常耳廓平均增长2.6cm2。88.9%现再造耳廓的面积大于等于原正常耳廓面积。80.0%现正常耳廓的面积大于等于原正常耳廓面积。差异有显著统计学意义。在大于13岁患者中，与原正常耳廓相比，现再造耳廓平均增长3.86cm2；现正常耳廓平均增长0.77cm2。90.5%现再造耳廓的面积大于等于原正常耳廓面积。85.7%现正常耳廓的面积大于等于原正常耳廓面积。原正常耳廓和现正常耳廓平均面积之间的差异无显著统计学意义；而原正常耳廓与现再造耳廓平均面积之间的差异有显著的统计学意义。结论：现再造耳廓平均面积生长快于现正常耳廓。再造耳廓和正常耳廓的生长都主要是在早期年龄段。再造耳廓生长速度可能超过正常耳廓的生长速度。 [关键词]外耳；修复外科手术；器官测量；随访研究 [中图分类号]R764.9 [文献标识码]A [文章编号]1008-6455（2011）10-1537-03 Epidemic study on the growth of reconstructed auricles GUO Wan-hou1,GUO Qiu-ju1,YANG Qing-hua2,ZUANG Hong-xing2,JIANG Hai-yue2 （1．Plastic Surgery Hospital of Tangshan Coal Medical College,Tangshan 063000,Hebei,China；2. Auditory Center of Plastic Surgery Hospital,Chinese Academy of Medical Science, Beijing 100041,China） Abstract:ObjectiveTo define the growth of the reconstructed ear by a long-term follow-up. This information serves to clarify the issue of proper sizing of the reconstructed ear, to make evident the early age at which reconstruction can begin.MethodsA epidemic study was performed. A total of 107cases of patients who underwent costal cartilage auricular reconstruction for grade Ⅲ unilateral microtia between 1994 and 2003 were reviewed after an interval of at least 2.5 years. Tracings of the original lead plates (from original medical records), the reconstructed ear and normal ear were made using exposed x-ray film. The tracings for each patients were evaluated by micro-electronics area measure instrument. The mean auricular size was examined for significance of interval change using the two