应用iwitness软件对单侧唇裂手术前后鼻唇部特征变化分析

发布时间：2018-05-29 11:25

本文选题：单数码摄影 + 三维测量　；参考：《遵义医学院》2014年硕士论文

【摘要】：目的利用iwitness三维重建测量软件对单侧唇裂术前术后鼻唇部特征及术后鼻唇部生长发育变化进行研究分析，以了解和掌握患者手术前后，手术后即刻效果与远期效果间的变化关系，为唇裂修复手术准确的定点设计提供参考意见。方法实验受测者为50名年龄为3个月到2岁不等的单侧唇裂患者，按唇裂类型将其分为两组，即单侧完全性唇裂组，共30人；单侧不完全性唇裂组，共20人；实验通过使用单数码摄影技术拍摄患者术前、术后及术后（至少术后三个月）复诊时三个时间点的面部不同角度的二维图像，再利用iwitness软件对图像进行三维重建并获取图像中各测量项目在三维空间中距离或者面积值；实验对所有受测者鼻唇部8个线性距离及上唇健患侧面积进行测量后，于各分组内进行术前健患侧对应测量项目的变化分析，手术后健患侧对应测量项目的变化分析，手术前后健侧测量项目的变化分析及手术前后患侧测量项目的变化分析，术后及术后复诊时健患侧对应测量项目比值的变化分析。实验中统计学分析软件使用SPSS l7.0，分析采用配对样本t检验。结果1.单侧完全性唇裂测量值变化规律：1）手术前健患侧唇峰口角距，健患侧的内侧唇高，健患侧的外侧唇高，健患侧上唇面积及健患侧鼻孔宽度，各组对比结果显示P＜0.01，有非常显著的统计学意义，除患侧鼻孔宽度测量值大于健侧外，其余测量项目患侧均小于健侧。2）手术前后健侧唇峰口角距，健侧的内侧唇高，健侧的外侧唇高，健侧上唇面积，患侧唇峰口角距，患侧的内侧唇高，患侧的外侧唇高，患侧鼻孔宽度及患侧上唇面积，各组对比结果显示P＜0.01，有非常显著的统计学意义，除患侧鼻孔宽度减小以外，其余各测量项目测量值术后均有不同程度的增加。3）术后健患侧的内侧唇高，健患侧鼻孔宽度及健患侧上唇面积，各组对比结果显示P＜0.01，有非常显著的统计学意义，术后患侧测量项目小于健侧。术后健患侧唇峰口角距，术后健患侧外侧唇高及手术前后健侧鼻孔宽度，各组对比结果显示P＞0.05，无显著的统计学差异义，手术后健患侧唇峰口角距及外侧唇高对称性恢复良好，健侧鼻孔跨度手术前后变化不明显。4）患者术后与术后远期复诊时健患侧对应测量项目比值的对比结果显示P＞0.05，无明显统计学意义。 2.单侧不完全性唇裂测量值变化规律：1）手术前健患侧唇峰口角距，健患侧的内侧唇高，健患侧的外侧唇高，健患侧上唇面积及健患侧鼻孔宽度，各组对比结果显示P＜0.01，，有非常显著的统计学差异，除患侧鼻孔宽度测量值大于健侧外，其余测量项目患侧均小于健侧。2）手术前后健侧的内侧唇高，健侧上唇面积，患侧唇峰口角距，患侧的外侧唇高，患侧的内侧唇高，患侧鼻孔宽度及患侧上唇面积，各组对比结果显示显示P＜0.01，有非常明显的统计学差异，除患侧鼻孔宽度减小以外，其余各测量项目测量值术后均有不同程度的增加。手术前后健侧唇峰口角距，健侧的外侧唇高及患侧外侧唇高，各组对比结果均显示P＞0.05，无明显的统计学差异。3）术后健患侧唇峰口角距，健患侧的内侧唇高及健患侧上唇面积，各组进行对比结果显示P＜0.01，有非常明显的统计学差异，术后各测量值小于健侧，但是测量值差距较小；术后健患侧外侧唇高及术后健患侧鼻孔宽度，各组对比结果显示P＞0.05，无明显的统计学差异，术后健患侧的外侧唇高及鼻孔宽度对称性恢复良好。4）患者术后与术后远期复诊时健患侧对应测量项目比值的对比结果显示P＞0.05，无明显统计学意义。结论1.单侧唇裂健患侧内侧唇高、外侧唇高、唇峰口角距术后均较术前有所增加，该结果提醒术者在进行设计时要考虑到裂隙关闭后组织测量值的变化，点与点的距离因组织张力的改变会有所改变。2.患侧唇峰点的确定是单侧唇裂修复术定点设计的重点，模拟唇裂修复后与健侧唇峰点相对称所确定的患侧唇峰点才能能获得良好的唇峰口角距对称性。3唇裂修复后的即刻效果与远期效果有所变化，因追踪病例太少及时间太短，没有获得明确结果。
[Abstract]:Objective to study and analyze the characteristics of nasolabial and the changes of nasolabial growth and development after the operation of unilateral cleft lip with iwitness three-dimensional reconstruction software, so as to understand and grasp the relationship between the immediate effect and the long-term effect before and after the operation, and provide reference for the accurate fixed-point design of the repair of cleft lip.
Methods 50 unilateral cleft lip patients aged from 3 months to 2 years old were divided into two groups according to the type of cleft lip, that is, unilateral complete cleft lip group, a total of 30 people, unilateral incomplete cleft lip group, and 20 people. The experiment was taken before, after and after the operation (at least three months after the operation) by single digital photography. A two-dimensional image of different angles of the face at three time points, and then the three-dimensional reconstruction of the image by iwitness software and the value of the distance or area in the three-dimensional space of the measurement items in the image. The experimental results were carried out before the 8 linear distances and the upper lip area of the labial lips of all the subjects. The change analysis of the side corresponding measurement items, the analysis of the changes of the corresponding measurement items on the healthy side after operation, the analysis of the changes of the side measurement items before and after the operation and the change analysis of the items of the affected side measurement before and after the operation, the analysis of the ratio of the corresponding measurement items on the healthy side of the patients after the operation and after the revisit. The statistical analysis software used SPSS L7 in the experiment. .0, a paired sample t test was used.
Results the change of the measured value of 1. unilateral complete cleft lip: 1) the angular distance of the lip peak of the patient before the operation, the height of the medial lip of the healthy side, the high lateral lip of the healthy side, the area of the upper lip of the healthy side, the width of the nostril on the healthy side. The results of each group showed P < 0.01, and the value of the width of the nostrils was greater than that of the healthy side. The other measurements were less than the healthy side.2), the lateral lip angle of the healthy side, the medial lip of the healthy side, the lateral lip of the healthy side, the upper lip area of the healthy side, the lateral lip area of the healthy side, the side lip angle, the lateral lip of the affected side, the lateral lip of the affected side, the lateral nostril width and the area of the upper lip of the side. The results of each group showed a very significant combination. In addition, in addition to the decrease of the width of the nasal nostrils, the measured values of the other measurement items increased.3 after operation. The medial labial height, the width of the nil and the area of the upper lip in the healthy side of the patients after the operation were P < 0.01. The results showed that there was a very significant statistical significance, and the postoperative patient side measurement was less than the healthy side. The posterior lip peak angle, the lateral lip height of the healthy side of the patient and the width of the lateral nostril before and after the operation showed that P > 0.05, there was no significant difference between the two groups, and the high symmetry of the lateral lip and the lateral lip after the operation was well restored, and the changes of the lateral nostril span were not obvious before and after the operation, and the postoperative and postoperative long term after operation were not obvious. The comparison of the corresponding ratio of the healthy side to the measurement item showed that the P > 0.05 was not statistically significant.
2. the change regularity of the measurement value of unilateral incomplete cleft lip: 1) the angle of the lip peak of the patients before the operation, the height of the medial lip of the healthy side, the high lateral lip of the healthy side, the area of the upper lip of the healthy side, the width of the nostril on the healthy side. The results of each group showed P < 0.01, there was a very significant statistical difference, and the measured value of the width of the nostril was greater than that of the healthy side. The lateral lip height of the healthy side, the area of the upper lip of the healthy side, the lateral lip angle of the side, the lateral lip of the affected side, the lateral lip of the affected side, the lateral lip of the affected side, the lateral nostril width and the area of the upper lip of the side of the affected side, the results showed that the width of the lateral nostrils and the area of the upper lip of the affected side of the affected side were lower than that of the healthy side.2. In addition, the measured values of the other measurements were increased in varying degrees. The lateral lip angle of the healthy side, the lateral lip of the healthy side, and the lateral lip of the affected side were high. The results of each group showed P > 0.05, no significant difference in statistics.3. The contrast results showed that P < 0.01, there was a very obvious statistical difference. The measured values were smaller than the healthy side, but the difference of the measured values was small. The lateral lip of the patients after the operation and the width of the nasal nostrils after the operation were P > 0.05. There was no significant difference. The lateral lip height and the width of the nostril were on the healthy side of the patients. A good recovery rate of.4) the comparison of the corresponding ratio between the healthy side and the postoperative side of the patients at postoperative long term follow-up showed that P > 0.05 had no significant statistical significance.
Conclusion 1. unilateral cleft lip with high medial lip, lateral lip high, and lip peak angle distance are all higher than before operation. This result reminds the operator to take into account the changes of tissue measurements after the closure of the fracture. The distance between point and point can be changed by the change of tissue tension, the determination of the.2. side lip peak point is a unilateral cleft lip repair. The focus of the design of the fixed-point design is to simulate the affected side lip peak point identified by the repair of the cleft lip with the healthy side lip peak. The immediate effect and the long-term effect of the.3 cleft lip repair with good lip peak angle distance can be changed, because the trace cases are too few and the time is too short, and no definite results have been obtained.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.21

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