鼻牙槽嵴塑形矫治器在单侧完全性唇腭裂鼻唇畸形矫治中的效果评价  

The effective evaluation of presurgical nasoalveolar molding with nasa stent and retention arm in complete unilateral cleft Lip and palate patients

作　　者：钟渝翔[1] 李万山[1] 李远贵[1] 陈梦苇[1] 廖礼姝[1] 梁丽[1] 左丁[1] 

机构地区：[1]重庆医科大学附属儿童医院口腔科,重庆400014

出　　处：《激光杂志》2012年第5期69-71,共3页Laser Journal

摘　　要：目的:客观评价带鼻撑与固位柱的鼻牙槽嵴塑形(presurgical nasoalveolar molding,PNAM)矫治器对单侧完全性唇腭裂患者鼻唇畸形的矫治效果。方法:选择符合纳入标准的三组病例各14例。病例组患者出生后1月内即使用带鼻撑及固位柱的PNAM矫治器同期完成鼻唇部与腭部畸形矫治。通过对三组对象标准鼻唇部正位及鼻底位照片的标记与测量,并对测量结果行配对t检验与多元方差分析,客观评价对鼻唇部的矫治效果。结果:PNAM矫治能使患者鼻尖高度,鼻小柱高度与宽度,双侧鼻孔高度、宽度、周长与面积及上唇面积明显增加(P<0.05),而双侧鼻翼高度差、鼻底裂隙宽度、鼻尖与鼻小柱倾斜度明显减小(P<0.05);但与正常组仍有差距(p<0.05);而非矫治病例其健侧鼻孔高度、周长与面积及上唇面积较矫治前有增大的趋势(P<0.05)。多元方差分析发现,EnW、BAW、CHW、NWR四项指标无差别(p>0.05)。结论:PNAM矫治是早期有效改善患者鼻唇部原发畸形的非手术治疗手段之一。Objective： To evaluate the orthopaedic effect of presurgical nasoalveolar molding （PNAM） devices with nasal stent and retention arm on the nasolabial deformities in complete unilateral cleft lip and palate patients（ UCCLP） , which the correction of nasolabial and palatal defomnties has been finished simuhaneously. Clinical Materials and Methods： A retrospective review was conducted. 14 cases were selected respectively in three groups, which met the inclusion criteria. Among them, and the cases in the study group were treated with modified PNAM appliances with nasal stent and retention arm within 1 menth after birth until cheilorrhaphy has been finished about three months old; and the patients in negfive control group failext to undergo PNAM treatment for various reasons, and the nasolabial and palat＇al development of objects in normal group is normal with about three months old. And the anatomic points on the photos of standard frontal view and subnasa view were warked and measured. The paired t - test and multivafiate analysis of variance were used to evaluate the effect on the nasolahial defomlities. Results： PNAM treatment can make the NTH, CL, CW, NHL, NIiR, NWL, NWR, NRCL, NRCR, NAL, NAR and LLA of UCCLP pationts significartly increased （P〈0.05）, and BAHD, CWN, NBD and CD of UCCLP patients significantly decreased （P〈O.05）. Nonetheless there was a difference with the case.s in normal group （ P 〈 O. 05 ）. And N HR, NRCR, NAR and LLA of the patients in control group had an increasing trend, which compared with the cases in study group before PNAM treatment （ P 〈 0.05 ）. Multivariate analysis of variance found that four indicators have no statistically significant difference （p 〉 O. 05）, wifich included EnW, BAW, CHW, NWR. Conclasions： The use of PNAM devies with nasal stent and retention can effectively improve the nasolabial defomaities of UCCL patients, and restore the triangular structure and the symmetry of the abnormal noses, and reduce the severity of the pr

关 键 词：鼻牙槽嵴塑形矫治器 单侧完全性唇腭裂 术前矫治 鼻唇畸形 配对t检验 多元方差分析 

分 类 号：R782.2[医药卫生—口腔医学]