【先天性单侧唇裂鼻畸形修复270例临床报告】唇裂鼻畸形修复

  [摘要] 目的 分析单侧唇裂畸形存在的鼻畸形情况,用美学修复理念进行个体化的设计。 方法 对270例单侧唇裂进行鼻畸形修复,根据原发和继发鼻畸形情况进行手术设计。 结果 本组对收治的270例单侧唇裂继发鼻畸形进行了术后分析,单侧唇裂Ⅱ度的继发畸形术后满意度为96.2%,单侧唇裂Ⅲ度的继发畸形术后满意度为73.8%,唇裂早期修复进行鼻整形的面容恢复优于唇裂术后继发鼻畸形后进行鼻整形的病例,两者差异有统计学意义(P < 0.05)。 结论 单侧唇裂的裂度与鼻畸形的程度呈正比,修复方法较为复杂和多样术式。对单侧唇裂鼻畸形采用对称性美学测量,重视鼻翼软骨的矫正,可达到对称性的美学效果。
  [关键词] 单侧唇裂;鼻畸形;美学修复
  [中图分类号] R622[文献标识码] A[文章编号] 1673-7210(2012)03(c)-0025-03
  Clinic reports on 270 cases of repairs of nose deformities of protal unilateral cleft lip
  LI Liya SHI Shenggen
  The Whole Army Oral Central of 306th Military Hospital of PLA, Beijing 100101, China
  [Abstract] Objective To analyze deformities of nose in unilateral cleft lip′s deformities, and to make design of individuation with idea of aesthetics repair. Methods Deformities of nose in unilateral cleft lip with 270 cases were repaired, operation design was made according to primary and secondary deformities of nose. Results Group analyzed after operation for secondary deformities of nose in unilateral cleft lip of treated 270 cases, that the secondary deformities for Ⅱ degree of unilateral cleft lip got 96.2% satisfied after operation, 73.8% satisfied after operation for the secondary deformities of Ⅲ degree, recuperate of face for early nose surgery of cleft lip were more good than the cases of nose surgery made after the secondary deformities of nose since cleft lip operation, the both had a statistically significant difference (P   1.3.3 术后护理
  术后1~2 d患侧鼻孔填塞凡士林纱条,达到止血和填充的作用,有条件可在换药后患侧鼻孔应用硅胶材料的支架充填(3个月左右),保持创面干燥。一般术后6~7 d拆线即可。以上方法可单独用于某一患者,也可几种方法联合应用。根据患者畸形程度灵活掌握应用。一般术后为了使软骨修复后维持正常解剖形态,在患侧鼻孔内应放置鼻孔支撑管2~3个月。
  1.4 统计学方法
  采用统计软件SPSS 13.0对实验数据进行分析,计数资料以率表示,采用χ2检验。以P