两种手术方法修复不完全性腭裂的临床效果比较

Clinical comparative study of two kinds of methods in surgical repair of isolated clefts

目的：比较Sommerlad腭帆提肌重建术与Von Langenbeck法修复不完全腭裂的临床效果方法：143例不完全性腭裂患者接受手术修复,其中54例（年龄1-6岁,平均2.6岁）行Sommerlad腭帆提肌重建术修复（T1组）、89例（1-8岁,平均3.2岁）行Von Langenbeck法修复（T2组）,术后1-4周随诊,采用临床回顾性研究的方法比较两组术后体温、出血、感染、进食、腭部穿孔率.结果：T1组平均术中出血量约18.6ml,T2组术中血量约34.2ml（P＜0.01）;T1组术后1例感染,5例发热,1例继发性出血;T2组术后4例感染,21例发热,3例继发性出血（P＜0.05）;T1组腭部穿孔3例,T2组腭部穿孔4例,两组间差异无统计学意义（P＞0.05）.结论：Sommerlad腭帆提肌重建术修复腭裂创伤小、术后并发症较少,推荐临床应用.

Objective To compare the clinical effect of Sommerlad versus Von Langenbeck technique repair of isolated clefts.Methods A consecutive series of 143 children born with isolated cleft palate between 2005 and 2011.Experimental group：54 cleft patients received palatopltsty with levator veli palatini retropositioning according to Sommerlad （ranged from 1 to 6 years,mean age 2.6 years）.Control group：89 cleft patients received Von Langenbeck technique （ranged from 1 to 8 years,mean age 3.2 years）.From medical records,the variables of blood loss,diet,temperature changes,wound healing,bleeding and postoperative perforation were observed and analyzed.Results In experimental group,one case of postoperative infection was found in all cases,5 patients had fever,and 1 patients developed bleeding.There were 4 patients with postoperative infection,21 patients with fever and 3 patients developed bleeding in control group.There was significant difference in the two groups （P＜ 0.05）.Postoperative cleft perforation occurred in 3 patients of experimental group,and 4 patients of control group （P＞0.05）.Blood loss was higher using the Yon Langenbeck technique （34.2m vs 18.6m,P＜0.01）.Conclusion The cleft palate repair technique according to Sommerlad in this study has been shown to result in less hurt and good postoperative recovery.