改良旋转推进法修复先天性单侧不完全性唇裂的临床研究  

Improved millard's method of primary repair for incomplete unilateral cleft lip patients

作　　者：王琳[1] 刘书会[1] 郑明[1] 邹永巍[1] 刘春丽[1] 

机构地区：[1]吉林大学口腔医院颌面外科,硕士生吉林130021

出　　处：《口腔颌面修复学杂志》2013年第4期207-212,共6页Chinese Journal of Prosthodontics

摘　　要：目的:探讨针对单侧不完全性唇裂的修复术式,改良经典旋转推进法,并应用于临床,通过主、客观评价探讨其效果。方法:选择30例单侧不完全性唇裂患者为研究对象。应用改良法手术:7点定于患侧裂隙顶点;患侧梯形推进瓣;保留旋转推进法切除组织。对术后拆线后照片,进行主观评价(VAS评分系统);客观数据以SPSS17.0统计软件包进行配对样本t检验。结果:主观评价中除鼻孔对称性及人中嵴形态外,均值接近8.0。客观评价:术后健患侧鼻翼口角距及健患侧鼻翼唇峰距差异无统计学意义(P>0.05),其余差异均有统计学意义(P<0.05)。健患侧唇峰口角距、鼻底宽及鼻孔宽度对称率较术前接近1,差异有统计学意义(P<0.01)。人中切迹点及鼻小柱基部中点偏离程度减小,回归率高于50%。结论:改良旋转推进法修复单侧不完全性唇裂可达到良好的美观效果,术后健患侧基本对称。Objective： To investigate a new operation design for unilateral incomplete cleft lip repair, modified on the Millard＇s method, and subjective and objective evaluations were performed to investigate its clinical effects. Methods： Thirty patients with unilateral incomplete cleft lip were randomly selected and the modified Millard＇ s method was performed. The characteristics of improved Millard＇s method were the change of point 7 and the quare flap B, keeping the Millard＇s method for tissue removal. Subjective evaluation （VAS score system） of photos after operations and the objective measure- ment data were calculated by SPSS17.0 statistical software package for paired samples T test. Results： The subjective eval- uation： the indices, except for the nostrils and philtral column, symmetry average were close to 8.0. Objective evaluation： the distance between nose and comer of the mouth and the distance between nose and lip peak after operation showed no statistical difference（P〉0.05）. And others showed statistical differences（P〈0.05）. The distance between lip peak and comer of the mouth, nasal bottom width and width of nostril symmetrical rate increased and the changes were statistically signifi- cant （P〈0.01）. Deviation degree of the middle of nose bottom and lip incisor decreased, and the homing rate achieved above 50%. Conclusion： The improved Millard＇ s method which was used to repair incomplete unilateral cleft palate could achieve favorable cosmetic results.

关 键 词：单侧不完全唇裂 旋转推进法 手术改良 

分 类 号：R782.2[医药卫生—口腔医学]