垂直转向红唇瓣修复唇裂二期唇珠区畸形的效果  

Vermilion tubercle reconstruction with a vermilion flap transferred vertically in secondary cleft lip repair

作　　者：周佳[1] 王健[1] 朱昌[1] 余力[1] 张波[1] 郑丹宁[1] Zhou Jia;Wang Jian;Zhu Chang;Yu Li;Zhang Bo;Zheng Danning(Department of Plastic and Reconstructive Surgery,Shanghai 9th People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,200011

出　　处：《中华医学美学美容杂志》2020年第4期298-301,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：上海市临床重点专科建设项目整形外科(SHSLCZDZK00901)。

摘　　要：目的探讨应用于唇裂二期患者唇珠畸形修复的手术方法。方法2015年1月至2015年12月,收集上海第九人民医院整复外科39例[男17例,女22例;年龄18~29(21.46±2.8)岁]唇裂二期患者资料,均采用垂直转向红唇瓣重建唇珠。术中将裂缘侧唇珠区域组织复位,同时用垂直转向的红唇补充红唇组织,深面肌肉组织瓣补充唇珠组织容量。测量术前后唇珠区红唇垂直向宽度和唇珠突度,两组数据进行配对t检验。调查术后效果患者自我评估,评估唇珠重建效果。结果垂直转向红唇瓣术后患者唇珠结构明显,唇珠形态饱满、居中,唇部整体形态立体感增强。无不良并发症。术后随访28例患者,平均9.71个月。术后中线处、裂侧唇峰、裂侧短臂中点处唇红宽度分别为(6.35±0.87)mm、(7.75±1.03)mm、(7.48±0.97)mm,与术前(5.32±0.91)mm、(3.98±0.89)mm、(4.30±0.86)mm比较明显增加,术前后组间比较差异有统计学意义。术后唇珠突度(0.83±0.51)mm较术前(0.38±0.46)mm明显增加,差异有统计学意义(P<0.05)。垂直转向红唇瓣重建唇珠有效率27例(96.4%)。结论垂直转向红唇瓣修复是一种用于唇裂二期唇珠重建的有效方法。Objective To present a new method of vermilion tubercle reconstruction in secondary cleft lip repair.Methods 39 secondary cleft lip repair patients underwent the operation of vermilion tubercle reconstruction with a vermilion flap transferred vertically.The procedures of the reconstruction mainly included three processes,restoring the vermilion tubercle tissue in the cleft area,widening the vermilion with the vermilion flap,and augmenting the volume of the tubercle with the muscle tissue underlying that vermilion flap.The width of the vermilion and the projection of the vermilion tubercle were measured before and after operation,and then two sets of data were analyzed with paired-samples t test.A patient satisfaction survey was performed postoperatively to evaluate the effect of the reconstruction.Results The reconstructions of vermilion tubercle were successful in all patients and no complications occurred.The most of new vermilion tubercles located in midline and appeared plump.Follow-up had been completed in 28 patients and the average follow-up period was(9.71±5.02)months.The effective vermilion width increase was from(5.32±0.91)mm,(3.98±0.89)mm,(4.30±0.86)mm before operation to(6.35±0.87)mm,(7.75±1.03)mm,(7.48±0.97)mm after operation in the midline of lip,the peak of cleft side and the midline of short arm,respectively.The postoperative width of vermilion in the cleft side was widened significantly.The projection of the tubercle was increased significantly from(0.38±0.46)mm to(0.83±0.51)mm.96.4%(27)patients achieved satisfied results of vermilion tubercle reconstruction after operation.Conclusions The vermilion flap transferred vertically has been found to be an effective method of vermilion tubercle reconstruction in the secondary repair of cleft lip.

关 键 词：唇裂 修复外科手术 唇珠重建 红唇瓣 垂直转向 二期修复 

分 类 号：R782.21[医药卫生—口腔医学]