Furlow腭成形术和两瓣法对腭裂患儿腭咽闭合功能的影响研究  

Effect of Furlow palatoplasty and two-flap method on palatopharyngeal closure in children with cleft palate

作　　者：杨静[1] 李永生[1] 王瑜[1] YANG Jing;LI Yong-sheng;WANG Yu(First People's Hospital of Yunnan Province,Kunming 640032,China)

机构地区：[1]云南省第一人民医院,640032

出　　处：《中国实用医药》2023年第13期65-67,共3页China Practical Medicine

基　　金：云南省科学技术厅-昆明医科大学基础研究联合专项资助[项目编号:2019FE001(-282)]。

摘　　要：目的 比较Furlow腭成形术和两瓣法对腭裂患儿腭咽闭合功能的影响。方法 100例腭裂患儿,根据手术方式的不同分成Furlow腭成形术组与两瓣法组。比较两组患儿PSA评分、头影测量及鼻咽纤维镜检查相关指标。结果 Furlow腭成形术组PSA评分0~2分37例,3~6分8例,7~13分5例;两瓣法组PSA评分0~2分27例,3~6分8例,7~13分15例。Furlow腭成形术组患儿PSA评分优于两瓣法组,差异具有统计学意义(P<0.05)。Furlow腭成形术组患儿咽腔深度/软腭长度(0.60±0.03)小于两瓣法组的(0.66±0.05),矢状位软腭运动闭合程度(92.85±6.13)%大于两瓣法组的(81.53±9.41)%,差异具有统计学意义(P<0.05);两组患儿软腭上抬角度比较,差异无统计学意义(P>0.05)。Furlow腭成形术组患儿术后腭咽闭合率为(90.10±5.35)%,大于两瓣法组的(78.25±7.01)%,差异具有统计学意义(P<0.05)。研究中,两组均出现了1例腭瘘患儿,发生率为2%。结论 腭裂患儿采用Furlow腭成形术与两瓣法进行修复手术均可获得较为良好的手术效果,但Furlow腭成形术应用腭帆提肌重建和反向Z成形,可获得更好的语音效果与腭咽闭合功能。Objective To compare the effect of Furlow palatoplasty and two-flap method on palatopharyngeal closure in children with cleft palate.Methods A total of 100 children with cleft palate were divided into Furlow palatoplasty group and two-flap group according to different surgical procedures.The PSA scores,cephalometric measurements and nasopharyngeal fiberscopy related indexes were compared between the two groups.Results In the Furlow palatinoplasty group,37 patients had PSA scores of 0-2 points,8 patients had PSA scores of 3-6 points,and 5 patients had PSA scores of 7-13 points.In the two-flap group,27 patients had PSA scores of 0-2 points,8 patients had PSA scores of 3-6 points,and 15 patients had PSA scores of 7-13 points.PSA score in Furlow palatinoplasty group was better than that in two-flap group,and the difference was statistically significant(P<0.05).The pharyngeal depth/soft palate length of(0.60±0.03)in the Furlow palatoplasty group was less than that of(0.66±0.05)in the two-flap group;the degree of motor closure of the soft palate in the sagittal position of(92.85±6.13)%in the Furlow palatoplasty group was greater than that of(81.53±9.41)%in the two-flap group;the differences were statistically significant(P<0.05).The difference between the two groups was not statistically significant(P>0.05)when comparing the elevation angle of soft palate.The postoperative palatopharyngeal closure rate of(90.10±5.35%)in the Furlow palatoplasty group was greater than that of(78.25±7.01%)in the two-flap group,and the difference was statistically significant(P<0.05).In the study,1 case of palatal fistula was seen in both groups,with an incidence of 2%.Conclusion Both Furlow palatoplasty and two-flap method can achieve better surgical results in children with cleft palate,but Furlow palatoplasty with levator veli palatini retropositioning and reverse Z-plasty results in better phonological outcomes and palatopharyngeal closure.

关 键 词：腭裂 Furlow腭成形术 两瓣法 腭咽闭合功能 

分 类 号：R782.2[医药卫生—口腔医学]