Furlow反向双Z法在腭裂修复术中的应用  

Application of Furlow's Double-opposing Z-palatoplasty for Cleft Palate Repair

作　　者：谢思田[1] 唐世杰[1] 张万聪[1] 彭立红[1] 

机构地区：[1]汕头大学医学院第二附属医院唇腭裂中心,广东汕头515041

出　　处：《汕头大学医学院学报》2011年第3期166-168,F0003,共4页Journal of Shantou University Medical College

摘　　要：目的：探讨Furlow反向双z法修复腭裂的疗效。方法：用Furlow反向双z法修复腭裂86例，术前、后测量左、右裂隙旁切牙腭侧到软腭后缘曲线距离与直线距离；术后3、6个月随访，主观语音判听，6个月后鼻咽纤维镜检查，年龄小未能配合检查者，于3-4周岁后可配合时复诊检查。结果：本组31例左、右裂隙旁切牙腭侧到软腭后缘曲线、直线长度均显著延长（P〈0．01）。59例语言评估，所有语音清晰度，高鼻音以及鼻漏气得到明显改善，但连续发音时仍有错误，需进一步语言治疗。其中22例术后6个月后进行鼻咽纤维镜检查，腭咽闭合率大于0．7占77．3％，其中闭合率0．9—1．0占22．7％。效果佳。结论：Furlow反向双Z法腭裂修复术可有效封闭裂隙，取得良好的腭咽闭合功能，语言效果良好，值得推广。Objective： To discuss the efficacy of Furlow＇s double-opposing Z-palatoplasty for cleft palate repair. Method： Eighty-six patients with cleft palate were operated with a combined Furlow and two-flap palatoplasty, the raw surface on the palate was closed by the Vomer flap, buccinator mucosal flap or pedicled buccal fat pad grin. Results： All the palates had satisfactory results without infection, difficulties in opening mouth and facial nerve injury. Thirty-one palates were measured for both a straight-line and a curved distance while the patient was under general anesthesia before and immediately after the palatoplasty. It demonstrated a significant elongation in palate（ P 〈 0.01）. Fifty-nine patients were followed up and perceptual speech evaluation demonstrated significant better speech outcomes. Twenty-two patients were evaluated by nasoendoscopic assessment of velopharyngeal function in more than 6 months after operation. The coefficients（77.3%） was better than 0.7, which 22.7% of them was between 0.9- 1.0. Conclusion： Two-flap and Furlow＇s double-opposing Z-palatoplasty can get a satisfactory soft palate lengthening and speech outcomes. It can avoid bone surface exposing and scar formation.

关 键 词：腭裂 Furlow反向双Z腭裂修复术 语音评估 

分 类 号：R782[医药卫生—口腔医学]