腭裂裂隙宽度与Sommerlad⁃Furlow法修复腭裂术后腭瘘发生率的关联研究  

Effect of preoperative width of cleft palate on fistula formation after Sommerlad⁃Furlow technique

作　　者：吴敏[1] 李承浩[1] 李扬[1] 龚彩霞[1] 石冰[1] Wu Min;Li Chenghao;Li Yang;Gong Caixia;Shi Bing(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Cleft Lip and Palate Surgery,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心,四川大学华西口腔医院唇腭裂外科,成都610041

出　　处：《国际口腔医学杂志》2021年第6期640-643,共4页International Journal of Stomatology

基　　金：四川大学华西口腔医院探索与研发项目(LCYJ2019-10)。

摘　　要：目的研究腭裂软硬腭的最宽处裂隙宽度对Sommerlad-Furlow法(简称SF法)修复腭裂术后腭瘘发生率的影响。方法对四川大学华西口腔医院唇腭裂外科2017年4月—2018年12月373例8~18月龄的行SF法一期腭裂硬腭无松弛切口术后患者的伤口进行观察,半年后随访,研究患者的腭瘘率。研究腭裂修复术后影响腭瘘的因素,观察指标为性别、年龄、手术医生、腭裂软硬腭的最宽处宽度和软硬腭的最宽处裂隙宽度/上颌结节后缘平面宽度。结果采用SF法腭裂修复术的总瘘孔率为6%。患者性别、年龄和手术医生在腭瘘发生率中差异无统计学意义(P>0.05)。将腭裂软硬腭的最宽处宽度裂隙分为4组:<5 mm裂隙宽度的患者18例,其中发生腭瘘0例;5~10 mm裂隙宽度的患者204例,发生腭瘘9例;10~15 mm裂隙宽度的患者137例,发生腭瘘11例;>15 mm裂隙宽度的患者14例,发生腭瘘3例。腭瘘发生率与腭裂裂隙宽度差异有统计学意义(P=0.048)。结论在新的修复技术下,腭裂术后腭瘘的发生与腭裂裂隙宽度和腭裂软硬腭的最宽处裂隙宽度/上颌结节后缘平面宽度的占比有相关性。Objective This study aimed to evaluate the association between postoperative palatal fistula formation and the ratio of cleft width to the sum of palatal-shelf width by using the Sommerlad-Furlow technique(SF technique for short) for primary palate repair. Methods A total of 373 patients aged 8-18 months who underwent Huaxi SF technique for primary cleft palate without relaxation incision from April 2017 to December 2018 were included in the study. The incidence of palatal fistula was followed up 6 months after surgery. Gender, age, surgeon’s qualification, and the ratio of cleft width to the sum of palatal-shelf width were considered as the potential factors for affecting palatal fistula formation.Results The effect of gender, age, and surgeon’s qualification had no statistical significance(P>0.05). The effect of the ratio of cleft width to the sum of palatal-shelf width on postoperative fistula formation showed a strong association(P=0.048), with a width <5 mm(18 patients, no palatal fistula), from 5 mm to 10 mm(204 patients, 9 with palatal fistula),from 10 mm to 15 mm(137 patients, 11 with palatal fistula), and a cleft width >15 mm(14 patients, 3 with palatal fistula). Conclusion This study confirmed that the occurrence of palatal fistula was closely related to the preoperative cleft width repaired through the SF technique.

关 键 词：腭裂 裂隙宽度 腭瘘 Sommerlad-Furlow法 

分 类 号：R782.22[医药卫生—口腔医学]