外耳再造耳后皮肤软组织扩张器植入后并发症现状及危险因素分析OA
Analysis of the current status and risk factors of complications after implantation of external ear reconstruction skin and soft tissue expander
目的 探讨外耳再造耳后皮肤软组织扩张器植入后并发症现状及危险因素,为临床干预措施的制定提供参考.方法 对 2020 年 1 月至 2023 年 3 月在我院接受耳后皮肤软组织扩张器植入的 151 例(163 耳)外耳再造患者临床资料进行回顾性分析,了解其并发症发生现状;根据耳后皮肤软组织扩张器植入后是否发生并发症,将其分为并发症组和无并发症组,并运用多因素Logistic回归分析外耳再造耳后皮肤软组织扩张器植入后并发症的危险因素.结果 本研究 163 耳有 37 耳发生并发症,并发症总发生率为 22.69%,其中血肿 18 例,占总并发症的 48.65%,感染 10 耳,占比 27.03%,切口裂开 4 耳,占比10.81%,扩张器外漏 3 耳,占比 8.11%,扩张器不张 1 耳,占比 2.70%,皮瓣坏死 1 耳,占比 2.70%;并发症发生平均时间为扩张器植入后(6.82±1.65)天.单因素分析结果显示,并发症组和无并发症组在年龄、居住地、引流管放置方式、扩张器容量、注水速度等方面存在组间差异,具有统计学意义(P﹤0.05);多因素Logistic回归分析显示,居住在农村(OR=2.079,95%CI:1.166～3.707,P=0.013)、引流管平位放置(OR=1.898,95%CI::0.962～3.748,P=0.065)、扩张器容量﹥100ml(OR=2.092,95%CI:1.128～3.878,P=0.019)、注水速度每周≥3 次(OR=1.962,95%CI:1.049～3.667,P=0.035)是耳后皮肤软组织扩张器植入后并发症发生的危险因素.结论 外耳再造耳后皮肤软组织扩张器植入后并发症发生率较高,居住在农村、引流管平位放置、扩张器容量＞100 ml、注水速度每周≥3次是并发症发生的危险因素,临床应根据患者实际情况选择合适的引流方式、扩张器容量,并实施科学的注射速度,以降低并发症发生率,为外耳再造提供充足皮瓣.
Objective Exploring the current situation and risk factors of complications after the implantation of external ear reconstruction skin and soft tissue expanders,providing reference for the development of clinical intervention measures.Methods A retrospective analysis was conducted on the clinical data of 151 patients(163 ears)with external ear reconstruction who underwent posterior ear skin soft tissue expander implantation in our hospital from January 2020 to March 2023,in order to understand the current status of complications;According to whether there are complications after the implantation of the skin and soft tissue expander behind the ear,it is divided into a complication group and a non complication group,and multiple logistic regression analysis is used to identify the risk factors for complications after the implantation of the skin and soft tissue expander after external ear reconstruction.Results In this study,complications occurred in 37 out of 163 ears,with a total incidence rate of 22.69%.Among them,there were 18 cases of hematoma,accounting for 48.65%of the total complications,10 ears of infection,accounting for 27.03%,4 ears of incision rupture,accounting for 10.81%,3 ears of dilator leakage,accounting for 8.11%,1 ear of dilator non opening,accounting for 2.70%,and 1 ear of flap necrosis,accounting for 2.70%;The average time for complications to occur is(6.82±1.65)days after the implantation of the dilator.The results of univariate analysis showed that there were statistically significant differences between the complication group and the non complication group in terms of age,place of residence,drainage tube placement method,expander capacity,and water injection speed(P<0.05);Multivariate logistic regression analysis showed that living in rural areas(OR=2.079,95%CI:1.166～3.707,P =0.013),flat placement of drainage tubes(OR=1.898,95%CI:0.962～3.748,P =0.065),expander capacity>100ml(OR=2.092,95%CI:1.128～3.878,P =0.019),and water injection rate≥3 times per week(OR=1.962,95%CI:1.049～3.667,P =0.035)were risk factors for postoperative complications of posterior ear skin and soft tissue expander implantation.Conclusion The incidence of complications after the implantation of a soft tissue expander for external ear reconstruction is relatively high.Living in rural areas,placing the drainage tube in a flat position,having a expander capacity greater than 100ml,and injecting water at a rate of≥3 times per week are risk factors for complications.Clinically,appropriate drainage methods and expander capacities should be selected based on the patient's actual situation,and scientific injection rates should be implemented to reduce the incidence of complications and provide sufficient skin flaps for external ear reconstruction.
周聪;代文意;尚蕾
南阳市中心医院,河南 南阳,473000
外耳再造耳后皮肤软组织扩张器并发症危险因素
External ear reconstructionBehind the earSkin and soft tissueDilatorComplicationsRisk factors
《中国医疗美容》 2024 (003)
14-18 / 5
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