大年龄腭裂患者术后腭咽闭合功能影响因素.docVIP

大年龄腭裂患者术后腭咽闭合功能影响因素 　　[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 [中图分类号] R 782.2 [文献标志码] A [doi] 10.7518/hxkq.2014.01.013 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. 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） [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， diag-nosis， operative age and method， were analyzed retrospectively. Results Cleft ratio 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 vel