腭帆提肌重建腭裂修补后的言语障碍矫治  

Speech disorder correction after cleft palate repair with levator veli palatini retropositioning

作　　者：闫大勇[1] 张瑞[1] 董汉华[1] 苏会芝 

机构地区：[1]郑州市中心医院耳鼻喉头颈外二科,河南省郑州市450000 [2]河北省优抚医院,河北省石家庄市050051

出　　处：《中国组织工程研究》2015年第46期7430-7434,共5页Chinese Journal of Tissue Engineering Research

基　　金：河北省卫生厅课题(20130451):非综合征性腭裂患儿修补术后语言功能训练的研究~~

摘　　要：背景:腭帆提肌重建腭裂修补仅从裂隙缘切口处行肌肉的解剖和功能重建,不需要两侧黏骨膜瓣的翻开,能使修补后达到较好的腭咽功能与语音效果。目的:比较腭帆提肌重建腭裂修补后与传统手术治疗言语障碍矫治的临床效果。方法:腭裂患儿176例根据数字随机表法分为治疗组与对照组各88例,对照组选择传统手术方法治疗,治疗组给予腭帆提肌重建腭裂修补治疗。结果与结论:治疗组腭裂修补后的语音清晰率为81.8%,对照组为54.5%,治疗组的语音清晰率明显高于对照组(P<0.05)。两组腭裂修补后的静止时软腭功能性长度、发音时软腭功能性长度、软腭上抬角与修补前对比都明显增加(P<0.05),同时修补后治疗组上述指标明显高于对照组(P<0.05)。两组腭裂修补后的高鼻音与鼻漏音评分与治疗前对比都明显下降(P<0.05),治疗组腭裂修补后的高鼻音与鼻漏音评分明显低于对照组(P<0.05)。结果说明,腭帆提肌重建腭裂修补能有效重建患者软腭肌作用,对腭咽闭合功能进行修复,对于矫治后解决言语问题,达到较好的语言效果有重要的意义。BACKGROUND：Cleft palate repair with levator veli palatini retropositioning can achieve good effects on pharyngeal function and voice quality by dissecting the muscle and rebuilding the muscle function only at the incision, without opening the mucoperiosteal flap, OBJECTIVE： To investigate the clinical effects of cleft palate repair with levator veli palatini retropositioning versus traditional surgery treatment on speech disorder correction. METHODS：Totaly 176 children with cleft palate were randomly assigned into treatment group and control group, 88 cases in each group. Patients were subjected to traditional surgery treatment in the control group and levator veli palatini retropositioning in the treatment group. RESULTS AND CONCLUSION：The postoperative speech inteligibility in the treatment group and the control group were 81.8% and 54.5%, respectively, and there was a significant difference between the two groups （P 〈 0.05）. After cleft palate repair, the folowing indicators were al improved in the two groups, including soft palate functional length at static state and when pronouncing, and soft palate elevation angle （P 〈 0.05）, and moreover, these indicators were better in the treatment group than the control group （P 〈 0.05）. Scores on high nasal tone and rhinorrhea tone were decreased significantly in the two groups after repair, and the scores were significantly＆nbsp;lower in the treatment group than the control group （P 〈 0.05）. These findings indicate that cleft palate repair with levator veli palatini retropositioning can effectively rebuild soft palate function and perfect velopharyngeal competence in patients, which is of great significance for speech disorder correction and voice quality recovery.

关 键 词：组织构建 组织工程 腭帆提肌 重建腭裂修补术 言语障碍 软腭 高鼻音 

分 类 号：R318[医药卫生—生物医学工程]