鼻中隔后动脉前唇岛状瓣修复完全性双侧唇裂前唇过短畸形  

Correction of complete bilateral cleft lip by using post nasal septal arterie＇s flap

作　　者：李爱群 寇波 张奎启[3] 关振群 王明华 孙勇刚[2] 蔡志刚[2] 李民 刘涛 

机构地区：[1]青岛市海慈医疗集团海慈医院口腔科,青岛266033 [2]北京大学医学部口腔医学院外科教研室 [3]大连医科大学口腔医学院

出　　处：《中华医学美学美容杂志》2010年第5期313-316,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的 探讨前唇长度不足的完全性双侧唇裂畸形的有效修复方法.方法 选择双侧完全性唇裂死婴新尸体2例,经氧化铅动脉灌注造影后,取鼻唇部组织拍X线片,了解其血供特点.临床上选择前唇长度明显不足的完全性双侧唇裂16例,利用其前唇血供特点,在鼻唇部做V形切口,使鼻小柱与前唇充分分离,形成近似带血管蒂的岛状前唇组织瓣,前唇便很容易下降到与侧唇对应的位置,解决了前唇长度不足的难点.然后,按照Millard的术式修复双侧唇裂.1年余后拍摄患者正、侧头位面像,在照片上测量鼻唇面各解剖标志点之间线性距离及角度,并与对照组30例正常婴幼儿比较,客观地评估手术效果及稳定性.结果 双侧完全性唇裂的前唇血供主要由鼻中隔后动脉供应.16例双侧唇裂患儿术后1年,上唇形态良好,测量的各项指数统计学处理显示：多数与正常婴幼儿对照组差异无统计学意义,客观上提示手术效果满意.结论 利用双侧唇裂患者前唇血供主要由鼻中隔后动脉供应的解剖特点,修复完全性双侧唇裂,可以有效地解决前唇过短的难题,术后效果理想、稳定.Objective To develop a new method for correction of the deformity of the complete bilateral cleft lip with short pre-lip. Methods Two specimens with the complete bilateral cleft lip was chosen to investigate the arterial supply to the pre-lip. The arteries were observed by radiography when the specimen was infused with lead oxide. 16 patients with the complete bilateral cleft lip and shortage in the length of pre-lip were enrolled in this study. Taking advantage of the unique character of arterial supply of complete bilateral cleft lip, those with short pre-lip were corrected. Photos of them were taken when preand post-operation for further measurement. And more than 1 year following-up was conducted to judge if the results were good enough or not. 30 babies were chosen as a control group to confirm the results of surgury objectively. Results Post nasal septal arteries were found to supply the pre-lip of the bilateral complete cleft lip. Appearance of 16 patients was good after surgery or 1 years later. There was no statistical significant difference between the patients and control group in the measurement data but nasal-lip angle. Conclusion It is an effective way to correct deformity of the bilateral cleft lip with short pre-lip by taking advantage of post nasal septal arterie＇s flap.

关 键 词：完全性双侧唇裂 唇裂修复 鼻中隔后动脉 前唇过短 

分 类 号：R7[医药卫生—临床医学]