华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

大年龄腭裂患者术后腭咽闭合功能的影响因素

邱叶1,2,3  郑谦3  石冰3  李杨3  王3  尹恒3   

  1. 1.重庆医科大学附属口腔医院大学城门诊部,重庆 401331;
    2.口腔疾病与生物医学重庆市重点实验室,重庆 401147;
    3.口腔疾病研究国家重点实验室华西口腔医院唇腭裂外科(四川大学),成都 610041
  • 出版日期:2014-02-01 发布日期:2014-02-01
  • 通讯作者: 郑谦,主任医师,博士, E-mail:zq652@163.com
  • 作者简介:邱叶,住院医师,硕士,E-mail:qyhfp@163.com

Influential factors affecting the postoperative velopharyngeal function among aged cleft palate patients

 Qiu Ye1,2,3, Zheng Qian3, Shi Bing3,Li Yang3,Wang Yan3, Yin Heng3   

  1. 1. Dept. of University Town Clinic, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401331, China; 2. Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing 401147, China; 3. State Key Laboratory of Oral Diseases, Dept. of Cleft and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Online:2014-02-01 Published:2014-02-01

摘要:

目的  研究2岁以上腭裂患者术后腭咽闭合功能的影响因素。方法  对245例2岁以上腭裂患儿术后腭咽闭合功能和可能影响术后腭咽闭合功能的因素(腭咽比值、腭裂类型、手术年龄、术式)进行回顾性研究。结果  腭咽闭合不全( VPI)组和腭咽闭合完全( VPC)组术前相对裂隙宽度、腭咽比值差异无统计学意义。不同年龄组、不同腭裂类型术后腭咽闭合率未见明显差异。不同的术式术后腭咽闭合率差异有统计学意义。结论  大年龄腭裂患者的治疗不宜照搬 2岁以下患儿单纯行腭裂整复术的常规治疗方案。裂隙的大小不是影响大年龄腭裂患者术后腭咽闭合功能的主要因素。 Sommerlad腭帆提肌重建术 +腭咽肌瓣咽成形术可明显改善大年龄患者术后腭咽闭合功能,在一期手术时应采用这种腭咽联合手术。

关键词:  , Sommerlad腭帆提肌重建术, 腭咽闭合功能, 腭咽闭合不全

Abstract:

 Objective  To determine the factors affecting post-operative velopharyngeal function of cleft palate patients aged over two years old. Methods  The data on 245 patients, including first visit case records and those in the database, were searched and recorded. Post-operative velopharyngeal function and clinical features, such as cleft ratio, adequate ratio, diagnosis, operative age and method,were analyzed retrospectively. Results Cleftratio and adequate ratio in the velopharyngeal competence (VPC) group were not statistically different from those in the velopharyngeal incompetence (VPI) group. The difference in VPC rate in different age groups and diagnosis was not significant. The post-operative VPC rates under different methods were significantly different. Conclusion  The current therapeutic schedule for patients younger than two years old is inappropriate for patients older than two years old. Cleft ratio is not the main factor affecting postoperative velopharygeal function. Sommerlad-Levator Veli Palatini reconstructional operation combined with sphincter pharyngoplasty can obviously improve the velopharyngeal function of patients aged  2 years old and up.This method should be applied in primary palatoplasty.

Key words:  Sommerlad-Levator Veli Palatini reconstructional operation, velopharyngeal function, velopharyngeal incompetence