Kuang Yuting,Zhao Sijun,Huang Min,et al.Analysis of psychological status, efficacy, safety and prognostic factors of modified Brent surgery in children with microtia[J].Journal of Clinical Pediatric Surgery,2022,21(09):876-880.[doi:10.3760/cma.j.cn101785-202207026-015]
改良Brent手术治疗小耳畸形的疗效及影响因素分析
- Title:
- Analysis of psychological status, efficacy, safety and prognostic factors of modified Brent surgery in children with microtia
- 关键词:
- 耳畸形; 获得性; 影响因素分析; 耳鼻咽喉科学/外科学
- Keywords:
- Ear Deformities; Acquired; Root Cause Analysis; Otolaryngology/SU
- 摘要:
- 目的 探讨改良Brent手术治疗小耳畸形的疗效及并发症，分析小耳畸形预后不良的影响因素。方法 选取湖南省儿童医院2020年1月至2021年3月收治的52例小耳畸形患儿作为研究对象，依照随机数字表法分为Brent组、改良Brent组，每组26例。Brent组实施传统Brent手术，改良Brent组实施改良Brent手术，改良Brent组在术前定位、软骨雕刻拼接以及手术分期的调整方面较Brent组进行了改良。对比两组并发症、小耳情况评分，采用多因素Logistic回归分析小耳畸形预后不良的影响因素。结果 两组的小耳情况评分均呈升高趋势，且改良Brent组T2~T3的分值更高；改良Brent组与Brent组的治疗有效率分别为92.31%（24/26）、69.23%（18/26）；改良Brent组与Brent组的并发症发生率分别为23.08%（6/26）、50.00%（13/26）；小耳畸形患儿预后不良的危险因素包括年龄较小、耳廓畸形Max Ⅲ型及以上、外耳道闭锁Ⅲ级及以上，保护因素是采用改良Brent手术（P<0.05）。结论 预后不良的危险因素包括年龄较小、耳廓畸形Max Ⅲ型及以上以及存在外耳道闭锁Ⅲ级及以上。改良Brent手术可以提高小耳畸形患儿的疗效，术后并发症的发生风险更低，值得临床推广。
- Abstract:
- Objective To investigate the efficacy and complications of modified Brent surgery in the treatment of microtia, and to analyze the influencing factors of poor prognosis.Methods A total of 52 children with microtia admitted to Hunan Children’s Hospital from January 2020 to March 2021 were selected as the research objects and divided into Brent surgery group and modified Brent surgery group according to the random number table method, with 26 cases in each group.Brent surgery was performed in the Brent surgery group, The modified Brent surgery group underwent modified Brent surgery, and the modified group was modified by preoperative positioning, cartilage carving and splicing, and adjustment of surgical stages..The complications and microtia score of the two groups were compared, and the influencing factors of poor prognosis of microtia were analyzed by multivariate Logistic regression.Results The small ear condition scores in both groups showed an upward trend, and the scores of T2-T3 in the modified Brent group were higher; the curative effects of the modified Brent surgery group and the Brent surgery group were 92.31% and 69.23%, respectively; the modified Brent surgery group and the Brent group The complication rates were 23.08% and 50.00%, respectively.Risk factors for poor prognosis in children with microtia included younger age, auricle deformity Max Ⅲ and above, external auditory canal atresia grade Ⅲ and above, and the protective factor was modified Brent surgery (P < 0.05).Conclusion Risk factors for poor prognosis include younger age, auricle deformity Max Ⅲ and above, and presence of external auditory canal atresia grade Ⅲ or above. The modified Brent operation can improve the postoperative curative effect of children with microtia, and the risk of postoperative complications is lower, which is worthy of clinical promotion.
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备注/Memo
收稿日期:2022-07-15。
基金项目:湖南省出生缺陷协同防治科技重大专项（2019SK1015）； 湖南省科技厅创新引导计划（2017SK50703）
通讯作者:赵斯君,Email:zhsj3991@sohu.com