单侧唇裂手术前后唇鼻部外观变化的数据分析

Changes of lip and nose in unilateral cleft lip patients before and after surgery： a data analysis

目的获得单侧唇裂患儿术前唇鼻形态的数据资料，根据唇鼻畸形特征设计手术修复方案，通过术后临床观察，评价手术效果。方法单侧唇裂患儿85例，分为单侧完全性唇裂组、单侧不完全性唇裂组。术前、术后6个月分别测量裂隙两侧唇长、唇高、人中嵴高度、鼻底宽度和鼻小柱高度，采用配对t检验来比较各组患儿裂隙两侧测量值的差异。结果单侧唇裂患儿术前裂隙两侧唇鼻部各项参数均有统计学意义（P〈0．01）；短期术后随访表明，两组1岁以内患儿在健一患侧唇长和鼻底宽度方面具有统计学意义（P〈0．01），裂隙侧唇长较健侧小，鼻底宽度较健侧大。完全性唇裂组患儿术后半年患侧鼻小柱高度小于健侧。1～2岁患儿在健一患侧唇长、唇高、人中嵴高度、鼻底宽度和鼻小柱高度方面差异无统计学意义。结论测量单侧唇裂患儿唇长、唇高、鼻底宽度、鼻小柱高度和人中嵴高度，对术前手术设计和术后对称性评估有很大的帮助。短期随访表明，1岁以内单侧唇裂患儿患侧唇长变短，鼻底增宽，在今后的唇裂修复中，需要通过改进手术方法来解决。

Objective To obtain the morphological characteristics data of lip and nose in unilateral cleft lip patients before operation, and design the surgical treating process according to the lip and nasal deformity. And to evaluate the effects of operation by the clinical observation after surgery. Methods Eighty-five unilateral cleft lip patients aged from 3 months to 2 years were divided into complete cleft lip group and incomplete cleft lip group. Lip length, lip height, philtrum column height, nostril width and eolumella height were measured before operation and at 6months after operation. Matched-pair t test analyses were used to assess the statistical significance of differences in cleft-side versus non-cleft-side measurements for each group. Results The meas- urement data of nose and lip were all significantly different between cleft-side and non-cleft-side before operation in unilateral cleft lip patients （ P 〈 0.01 ）. Statistically significant differences in lip length and nostril width were observed for both groups in short-term follow-up. The lip length in the cleft-side were less than those in non-cleft-side , and the nostril width were larger than that in non-cleft-side. The columella height in complete cleft lip group was less than that of non-cleft-side in the sixth month. No statistical significance was found in 1 -2 years patients in lip length, lip height, phihrum column height, nostril width and columella height. Con- clusion Measurements of lip length, lip height, phihrum column height, nostril width and eolumella height were useful in surgical design before operation and asymmetry evaluation after surgery in unilateral cleft lip patients. A short lip and wide nostril base were observed in short-term follow-up in young patients （ 〈 1 year） , which was necessary to solve with further modification technique.