改良术式在单侧不完全性唇裂整复治疗的应用  

A modified method for unilateral incomplete cleft lip

作　　者：叶向阳[1] 邱林[1] 田晓菲[1] 傅跃先[1] 刘燕[1] 肖军[1] 李天武[1] Ye Xiangyang Qiu Lin Tian Xiaofei Fu Yuexian Liu Yan Xiao Jun Li Tianwu(Department of Burns and Plastic ,the Children＇s Hospital, Chongqing Medical Unlversity,Ministry of Education Key Laboratory of Child Development and Disorders ,Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorder)

机构地区：[1]重庆医科大学附属儿童医院整形外科、儿童发育疾病研究教育部重点实验室、重庆市儿科学重点实验室、重庆市(儿童发育重大疾病诊治与预防)国际科技合作基地,重庆400014

出　　处：《重庆医科大学学报》2016年第12期1303-1306,共4页Journal of Chongqing Medical University

基　　金：国家临床重点专科建设资助项目(编号:国卫办医函【2013】544);重庆市科技计划资助项目(编号:cstc 2013jcyjA10018)

摘　　要：目的：探讨单侧不完全性唇裂的改良手术方式,以获得更为满意的手术效果。方法：选取我院2014年1月至2015年5月期间单侧不完全唇裂59例,设计改良直线切口术式进行唇裂修复,并同时进行初期鼻畸形修复。术后对唇鼻软组织进行精确测量,并由3名专科医师对手术效果进行主观与客观评价。结果：本组共进行59例病例,年龄从19天~9.7岁。随访6月~1.5年,所有病例唇部修复取得良好手术效果,患侧切口瘢痕位于人中嵴,重建人中自然,避免患侧鼻底及鼻小柱下方瘢痕;唇高满意,唇弓线明显,唇红线及唇红缘整齐弧线良好;上唇运动时口轮匝肌连续性好,患侧无局部球状突起。38例鼻部畸形矫正取得良好效果,双侧鼻孔基本对称,鼻底宽度一致,鼻穹窿高度满意;12例鼻部畸形取得中等良好矫正效果,患侧鼻孔较健侧略为低平;9例鼻形维持效果差,2月后鼻穹窿下移回复明显（术后未佩戴鼻模）。结论：本改良术式运用于单侧不完全性唇裂,可获得接近于自然唇鼻形态更为良好的术后效果。Objective：To explore improved method of incomplete unilateral cleft lip in order to achieve more cosmetic operative effect.Methods：Fifty-nine patients with unilateral incomplete cleft lip were randomly selected in the hospital from January 2014 to May2015,and the modified method was performed. Incision of Changgeng＇s method was applied to affected nasal at the same time.The effect was measured exactly after operation for objec-tive evaluation. Results：Fifty patients aged from 19 days to 9.7years were treated with this modified method. All the patients presented natural philtrum structure. The scars were at the philtrum ridge;the labial arch was in good shape and the red lips were well-stacked. Regularity of red labial margin was showed. Continual orbicularis oris muscle was observed when lip exercising. Thirty-eight cases of primary nasal repair were successful;both nostrils were in symmetry. Moderate corrective effects were observed in 12 cases. Affected nostril showed a little lower and flatter than another side. Ala nasi of 9 cases without wearing nasal model was collapsed unexpectedly after 2 months. Conclusion：With this modified method of incomplete unilateral cleft lip,the postoperative result can more approach nature natural lip nasal structure.

关 键 词：单侧不完全性唇裂 修复 改良术式 

分 类 号：R726.2[医药卫生—儿科]