腭裂术后腭瘘的分类及其修复研究进展  

Advances in classification and reconstruction of palatal fistula after cleft palate operation

作　　者：艾皮孜古丽·亚库普 亚尔肯·阿吉 许辉[3] AIPIZIGULI Yakupu;YAERKEN Aji;XU Hui(Postgraduate College of Xinjiang Medical University,Urumqi 830011,China;De-partment of Stomatology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830011,China;Department of Oral and Maxillofacial Surgery,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830011,China)

机构地区：[1]新疆医科大学研究生院,新疆维吾尔自治区乌鲁木齐830011 [2]新疆维吾尔自治区人民医院口腔科,新疆维吾尔自治区乌鲁木齐830011 [3]新疆维吾尔自治区人民医院口腔颌面外科,新疆维吾尔自治区乌鲁木齐830011

出　　处：《口腔疾病防治》2021年第2期140-144,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：新疆维吾尔自治区自然科学基金项目(2015211C203)。

摘　　要：腭瘘是腭裂术后最常见的并发症,影响患者的口腔卫生、语言功能及心理健康。目前腭瘘的定义及分类不尽相同,故腭瘘发生率的报道差异较大,发生率为0.8%~60%。本文对腭瘘的定义、分类及其修复方法进行综述。文献复习结果表明,目前缺少对腭瘘一致的定义及能全面反映腭瘘特点的分类法。腭瘘的修复方法有以下几种:邻近瓣主要用于穿孔<1 cm,且周围组织量足够的腭瘘修复;蒂在前的薄层舌背黏膜瓣是较大腭瘘的最常用方法;游离瓣主要适用于邻近瓣和带蒂都难以修复的顽固性及复杂的腭瘘;术中植入生物膜,形成3层封闭有助于减少创口复裂。离子体功能化电纺复合聚合物膜具有促血管形成作用,弹性及生物相容性良好,在动物模型上取得了良好的效果,但在人体上的安全性有待进一步研究。Postoperative fistulae are one of the most significant complications of cleft palate repair.They usually has an adverse effect on patients’oral hygiene,speech and even mental health.There has been a wide range of rates of fis⁃tula occurrence,from 0.8%⁃60%,with the classification and definition of fistulae differing from one author to the next.In this paper,the definition and classification of palatal fistulae and their reconstruction method are reviewed.At pres⁃ent,there is a lack of a consistent definition of palatal fistulae and a classification that can fully reflect the characteris⁃tics of palatal fistula.Adjacent flap is mainly used for repairing small fistulae with an adequate amount of surrounding tissue;anteriorly based dorsal tongue flaps are a safe and reliable method for large fistulae;free flap is beneficial for re⁃fractory and complicated palatal fistulae that are difficult to repair by the local and pedicle flap;and different synthetic materials are used in multilayer repair of fistulae;among them,composite polymer membrane is highly biocompatible,promoting cell attachment and proliferation in animal models,but its security in the human body needs further research.

关 键 词：腭裂 腭瘘 口鼻瘘 修复 生物材料 腭裂语音 语音清晰度 腭咽闭合不全 

分 类 号：R782[医药卫生—口腔医学]