腭裂修复术后松弛切口3种不同处理方式临床效果研究

The clinical effectiveness study of three kinds of different processing methods for relaxation incision in palatoplasty

目的研究腭裂修复术后松弛切口3种不同处理方式的临床疗效。方法回顾性分析2009年1月至2012年6月中国医科大学口腔医学院口腔颌面外科收治的113例行两大瓣法腭成形术患者的临床资料。按照术后松弛切口的处理方式不同将其分为3组:碘仿纱条组(36例)、旷置组(39例)、止血纱布组(38例)。比较3组患者术后发热、出血、恶心、感染、穿孔、复裂等情况。结果 3组患者术后第1天发热率差异无统计学意义(P>0.05);碘仿纱条组患者术后第3、5天发热率明显高其他2组(均P<0.05)。碘仿纱条组患者术后出血、恶心的发生率明显多于其他2组,差异有统计学意义(P<0.05);旷置组患者出血的发生率也明显多于止血纱布组,差异有统计学意义(P<0.05);3组患者术后感染、穿孔、复裂的发生率差异均无统计学意义(P>0.05)。结论松弛切口旷置法及填塞可吸收性止血纱布法疗效理想,适合临床推广。

Objective To compare the clinical effect of different treatments for relaxation incision in palatoplasty, post- operative reaction and ineision healing. Methods Totally 113 patients with cleft palate were divided into three groups randomly, who underwent palatoplasty. Iodoform gauze , nothing or ahsorbable hemostatic gauze was used on both sides of the relaxation incision. After surgery, the diet, temperature changes, wound healing and bleeding, postoperative cleft or pertbration were observed and analyzed. Results In Iodoform gauze group, 2 cases of postoperative infection were found in all cases, 12 patients had fever on the 3ird day, 16 patients developed bleeding and one patient had postoperative cleft perforation. There were 4 and 5 patients with fever on the 3rd day of postoperation in the other two groups. Conclusion Nothing and filling into relaxation incision with absorbable hemostatic gauze are more helpful for wound healing and post- operative recovery in palatoplasty.