α―氰基丙烯酸酯医用胶在腭裂修复术中应用与分析.docVIP

α―氰基丙烯酸酯医用胶在腭裂修复术中应用与分析 　　[摘要]目的：介绍α-氰基丙烯酸酯医用胶在腭裂修复术中的使用方法，分析应用效果及注意事项。方法：采用α-氰基丙烯酸酯医用胶对97例两大瓣法腭裂手术创面进行处理。将两大瓣与腭部创面定位粘合。松弛切口创面止血，封闭两大瓣边缘与硬腭缝隙。粘合固定上颌结节后方松弛切口碘仿塞。结果：术后仅4例创面有明显渗血。97例口腔呼吸道通畅，易于护理，无误吸及呼吸道梗阻并发症，两大瓣与硬腭粘合贴附可靠。术后碘仿塞固位好，仅7例提前脱出。术后创面愈合正常，效果满意。结论：α-氰基丙烯酸酯医用胶在腭裂修复术中，可有效粘合腭粘膜瓣，封闭创面减少渗血，固定碘仿塞，有利于术后呼吸道护理及创面愈合，操作方法简便安全。 　　[关键词]腭裂；手术；α-氰基丙烯酸酯；医用胶 　　[中图分类号]R782 [文献标识码]A [文章编号]1008-6455（2014）21-1787-03 　　Abstract： Objective To introduce the method of using α-cyanoacrylate medical adhesive in cleft palate repair operation， analyzes its effect and the matters needing attention. Methods The wound after two-flap operation of 97 cleft palate patients was treated with α-cyanoacrylate medical adhesive：made two-flap adhere tightly to hard palate and nasal mucosa wound； stopped bleeding on relaxation incision wound； closed the gap between two-flap and hard palate；fixed iodoform tampon into the relaxation incision behind maxillary tuberosity. Results In 97 cases，only 4 cases were obvious oozing of blood. The oral airway of all patients was smooth， the respiratory tract was easy to be cared， no aspiration and airway obstruction and other complications. The adhesion between two-flap and hard palate was reliable， the retention of iodoform plug was good. The operation wound healing was normal and satisfactory. Conclusion In repair operation of cleft palate， using α-cyanoacrylate medical adhesive can effectively adhere palate mucosa flap， close operation wound， reduce ooze blood， fix iodoform plug. It is conducive to postoperative respiratory care and wound healing.The method is simple and safe. 　　Key words：cleft palate； operation； α-cyanoacrylate； medical adhesive 　　腭裂手术创面止血和腭黏膜组织瓣与腭部创面的紧密贴附，对术后呼吸道护理、创面的正常愈合、减少并发症有很大的影响。笔者应用α-氰基丙烯酸酯医用胶（α-cyanoacrylate medical adhesive，α-胶）对两大瓣腭裂手术后创面进行处理，取得了良好的效果，现报道如下。 　　1 资料和方法 　　1.1一般资料：笔者2006年1月～2013年12月采用两大瓣腭成形法手术治疗的腭裂患者97例，其中年龄1～3岁者69例（占比71%），4～6岁者15例，≥7岁者13例；先天性Ⅱ°腭裂60例，单侧Ⅲ°腭裂28例，双侧Ⅲ°腭裂9例。所有病例均常规术前检查，排除手术禁忌证。 　　1.2方法 　　1.2.1手术方法：手术在