先天性单侧唇裂新临床分类的探讨

On A New Classification Method of Congenital Unilateral Cleft Lip

作者基于多年的临床观察和实践,在测量近200例先天性单侧唇裂病例的基础上,通过分析研究。发现患侧人中嵴高度、患侧唇健侧份鼻底宽度、患侧唇峰口角距及患侧红唇嵴角这四个因素的变化,与患侧唇面积的大小有密切的关系。根据本组资料分析,提出了按唇裂上唇面积特点的新临床四度分类法,即 A 度唇裂(最轻度),B 度唇裂(轻度),C 度唇裂(中度),D 度唇裂(重度),本分类法,有助于术前手术方法的选择及手术效果的预测,并使唇裂手术效果的评价更为客观。

The traditional“The three-grade classification method”in classifying congenital un-ilateral cleft lip has been used for decades,it is easy to understand and clear in explainingdefective development during fetal stage.However,this method fails to characterize eachcleft lip patient,so it is somewhat limited in this respect.We have measured nearly 200 cases of unilateral cleft lip patients,the analyses of the data obtained show that the lip area of the cleft side is closely related to the followingfactors:1.the height of the philtrum ridge on the cleft side;2.the width of the nosefloor just close to the cleft on the normal side;3.the vermilion angle(the angle of vermi-lion ridge and the line between corner of mouth and base of nose);4.the distance betweenthe lip peak and the corner of the mouth.Thus we suggest a new“Four grade clinical cl-assification method”according to the characteristics of the area of the cleft lip.These are:Grade A(most mild):The difference between the height of the philtrum on both sides(dh)is less than 3mm(<3mm)and the ratio of the area a_1 and A_1(a_1/A_1)is more than80%.Grade B(mild):dh 4-5mm a_1/A_1,71-80%.Grade C(moderate):dh 5.1-6mm a_1/A_160-70%.Grade D(severe):dh over 6mm a_1/A_1<60%.This method is able to specify each unilateral cleft lip patient,thus helps doctors tochoose the appropriate operation method better,predicts the outcome of the surgical process,makes the evalution of the operation results more objective.Some problems centred aroundthis topic are disscused.