无覆盖带蒂颊脂垫瓣移植在修复儿童腭裂中的临床研究

发布时间：2018-05-15 18:32

  本文选题：腭裂 + 义齿　； 参考：《重庆医学》2017年26期

【摘要】：目的探讨无覆盖带蒂颊脂垫瓣处理儿童腭裂修复手术中松弛切口的临床应用价值。方法选择2010年5月至2012年7月于该院就诊时被收治研的患儿共40例,在腭裂修复手术中分别采取无覆盖带蒂颊脂垫瓣移植(研究组,n=20)和碘仿纱条填充(对照组,n=20)处理松弛切口,比较术后腭瘘和发热等并发症。随访4年评估上颌骨发育。结果研究组18例患儿术后创口均达一期愈合,有效率为90%;对照组12例患儿创面愈合良好,有效率为60%,两组有效率比较差异有统计学意义(P0.05)。术后1周观察患儿创面,研究组2例(10%)创面血;对照组4例(20%)创面渗血,2例(10%)创面穿孔和2例(10%)腭瘘。两组并发症发生率比较差异有统计学意义(P0.05)。术后1个月,研究组患儿持续发热时间较对照组更短(P0.05),研究组术后患儿血清hs-CRP水平比对照组低(P0.05)。术后随访4年,研究组患儿上颌骨发育较对照组明显改善。结论应用无覆盖带蒂颊脂垫瓣处理儿童腭裂修复手术中松弛切口可改善术后并发症发生率和患儿上颌骨发育。
[Abstract]:Objective to evaluate the clinical value of flabby incision in the repair of cleft palate in children with buccal fat flap without covered pedicle. Methods from May 2010 to July 2012, 40 children with cleft palate were treated with uncovered buccal fat pad graft (study group) and iodoform gauze filling (control group). Postoperative complications such as palatal fistula and fever were compared. Maxillary development was evaluated after 4 years follow-up. Results the wound healing rate was 90% in the study group (n = 18) and 60 in the control group (n = 12). The difference between the two groups was statistically significant (P 0.05). 1 week after operation, the wounds were observed in the study group (n = 2), in the control group (n = 4, n = 20) the blood leakage was found in 2 cases (n = 10), the wound was perforated in 2 cases, and in 2 cases, there was a palatal fistula. There was significant difference in the incidence of complications between the two groups (P 0.05). One month after operation, the duration of fever in the study group was shorter than that in the control group, and the serum hs-CRP level in the study group was lower than that in the control group. After 4 years follow-up, the maxillary development in the study group was significantly improved than that in the control group. Conclusion the application of buccal fat flap without covered pedicle in the treatment of children with cleft palate can improve the incidence of postoperative complications and maxillary development in children with cleft palate.
【作者单位】： 云南省昆明市儿童医院口腔科;
【分类号】：R782.2
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本文编号：1893439