双侧唇裂的唇部解剖结构研究

A study on anatomy and struture of bilateral cleft lip

目的进一步了解双侧唇裂的解剖结构特点，以促进功能性修复的实施与开展。方法利用各型双侧唇裂（包括初次与二次）手术所切取的标本进行组织学、扫描电镜（ＳＥＭ）及透射电镜（ＴＥＭ）的观察研究。结果发现完全性双侧唇裂的前唇部无肌纤维，双侧不完全性唇裂的前唇及桥部有少量肌纤维，但其超微结构有变异；用直线缝合法修复的完全性双侧唇裂的前唇部，有从侧唇增生的肌纤维，但稀少，超微结构亦有变异。结论双侧唇裂既有外形的畸形，也有肌纤维形态及超微结构的变异，无论完全性或不完全性双侧唇裂都需行功能性恢复，才能获得良好的前唇部肌肉及功能结果１．双侧完全性唇裂的前唇中无肌纤维，含有大量的结缔组织。包括胶原纤维、脂肪、毛细血管及成纤维细胞。其中胶原纤维数量较多，密集排列，粗细不等，分布较均匀，大部分为网状胶原纤维，少量为粗大的胶原纤维束。在同一扫描电镜的断面上，成纤维细胞较大，多核，细胞器丰富，脂肪组织聚集成岛状或大小不等的颗粒样分散在胶原纤维之间。毛细血管较稀，管壁较薄，穿行于密集的胶原纤维之间（图１，２）。２．双侧唇裂的侧唇唇红内有纵横交错的肌纤维，浅层的肌纤维大多与裂缘平行，深层肌纤维则与裂缘垂直或交错。完全性双侧唇裂的侧图１双侧完全?

Objective To further research the characteristics of the anatomy structure of bilateral cleft lip(BCL) for the promotion of the performance of functional muscle repair.Methods Specimens of every type of BCL lips including those obtained from the primary and secondary operations were used to have the histology observation and transmission electron microscope(TEM) or scanning electron microscope(SEM)study.Results It showed that the prolabium of complete BCL had no muscle, there were only weblike collagen fibers of bundles of them, capillaries, fats and fats and fiber-blasts. There were muscle fibers in prolabium and bridges of incomplete BCL,but ultra structure variations were found. The prolabium of complete BCL operated on with straight line suture method had muscle fibers proliferated from the lateral lips, but the fibers were sparse and also had ultra structure variations.Conclusion The result shows that there are not only appearance malformations, but also muscle fiber ultra structure variations for BCL. No matter complete or incomplete the BCL is, the good prolabium muscles can only be obtained through the functional muscle repair.