Sommerlad腭帆提肌重建术修复不完全腭裂后创面愈合情况的研究

发布时间：2018-06-26 04:40

  本文选题：不完全腭裂 + Sommerlad腭帆提肌重建术　； 参考：《中国修复重建外科杂志》2014年07期

【摘要】：目的通过与Von Langenbeck法比较,分析Sommerlad腭帆提肌重建术修复不完全腭裂后创面愈合情况,探讨该术式对上颌生长抑制的影响。方法以2005年6月-2011年8月,采用Sommerlad腭帆提肌重建术修复的54例不完全腭裂患儿作为试验组;2003年6月-2006年9月,采用Von Langenbeck法修复的89例患儿作为对照组。两组患儿性别、年龄比较,差异均无统计学意义(P0.05),具有可比性。比较两组手术时间、术中出血量、术后体温及发热情况;随访腭部创面愈合情况,按照Karsten等的腭裂术后腭部瘢痕分级标准进行分级。结果试验组手术时间为(72.2±5.5)min,较对照组(58.1±6.8)min延长;术中出血量为(18.6±6.5)mL,较对照组(34.2±10.2)mL显著减少;差异均有统计学意义(t=4.494,P=0.000;t=2.447,P=0.000)。术后48 h内试验组患儿最高体温为36.6~37.6℃,平均36.9℃,其中发热5例(9.3%);对照组为36.8~38.2℃,平均37.3℃,其中发热21例(23.6%);两组比较差异有统计学意义(χ2=4.640,P=0.030)。两组患儿术后均获随访,其中试验组随访时间3~18个月,平均9个月;对照组随访时间3~6年,平均4年。术后3个月根据Karsten等的腭裂术后腭部瘢痕愈合分级标准,试验组0级38例、1级13例、2级3例,对照组0级6例、1级35例、2级48例,比较差异有统计学意义(Z=—7.785,P=0.000)。结论与Von Langenbeck法相比,Sommerlad腭帆提肌重建术修复不完全腭裂创伤小、术后瘢痕愈合轻,提示对上颌生长抑制影响较小。
[Abstract]:Objective to investigate the effect of Sommerlad palatine levator muscle reconstruction on maxillary growth inhibition by comparing with Von Langenbeck method. Methods from June 2005 to August 2011, 54 children with incomplete cleft palate were treated with Sommerlad levator palatalis reconstruction and 89 children with Von Langenbeck method as control group from June 2003 to September 2006. There was no significant difference in sex and age between the two groups (P0.05). The operative time, blood loss, body temperature and fever were compared between the two groups, and the wound healing of palatoplasty was followed up according to Karsten's criteria of cleft palate scar grading. Results the operative time was (72.2 卤5.5) min in the trial group, which was longer than that in the control group (58.1 卤6.8) min, and the intraoperative blood loss was (18.6 卤6.5) mL, which was significantly lower than that in the control group (34.2 卤10.2) mL. Within 48 hours after operation, the highest body temperature of the test group was 36.6 鈩，

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