8点法在双侧唇裂中的临床研究

Clinical study of 8 point method in bilateral cleft lip

目的寻找一种能使双侧唇裂修复术后唇峰、唇弓形态对称,增加上唇高度,减小鼻唇角度及恢复人中形态美观的手术方式。方法对2010年～2015年53例双侧唇裂患者运用一种新的整复术式,对传统的术式（直线原长法）进行改良。手术定点设计增加至8点,点3使2～3～4较2～3连线延长,增加了前唇的长度,减小了鼻唇的角度,一定程度上缓解了原长法前唇高度不足的问题。标准术前、术后、随访照片进行对比。结果患者术后无局部感染、出血、复裂,切口均一期愈合。术后随访例数47例,随访率89%。随访时间最短1个月,最长36个月,平均19个月。术后随访患者均鼻底部分组织闭合良好,双侧鼻翼略塌陷;手术切口疤痕不明显,良好地模拟了人中嵴形态;两侧唇峰对称,唇弓线连续性良好,形态对称,唇珠饱满,上唇高度自然延长,鼻唇角度减小,人中形态及外观恢复良好,疗效满意。结论这种改良方法定点设计简单、切口隐蔽,缝合后切口模拟形成了自然人中嵴与唇弓,术后疤痕少,且在轮廓线上,对称性好,能最大程度恢复患者鼻唇外观,手术效果满意,从而为临床上双侧唇裂修复提供具有更美观、实用和可行的手术方法。

Objective To find a can make the bilateral cleft lip repair,lip bow shape is symmetrical,postoperative lip peak height of upper lip,reduce the nasolabial angle and recover the original shape of cosmetic surgery.Methods From 2010 to 2015 53 cases of bilateral cleft lip patients using a new kind of reconstructive surgery,the traditional suegery（linear former minister）improved.Surgery fixed design increases to 8 points,3 make the 2-3-4 is 2-3 cords extend,increase the length of the front lip,reduced the nasolabial Amgle,to some extent alleviate the problem of insuf？ cient lip height before the traditional method.Standard preoperative、 postoperative and follow-up photos were compared.Results Patients with postpeative local infection、 hemorrhage、 after cracking,were primary healing of incisin.47 cases were followed in 53 samples. Shortest time 1month follow-up,the longest 36 months,an average of 19months.Postoperative follow-upp of patients with nasal floor organization closed good,bilateral nose slightly sunken;incision scar is not obvious,well simulate the crest of form;lip peaks on both sides is symmetrical,labial arch wire continuity is good,the shape is symmetrical,full,lip bead height naturally,lengthening nasolabial Angle decreases,and the recovery of form and appearance is good,the curative effect is satisfied.Conclusions Fixed-point design this improved method is simple and hidden incision,suture of incisin after simulated formed a natural person in the crest and labial arch,less postoperative scar,and the contour line,good symmetry,can maximize the recovery in patients with nasal lip appearance,with satisfactory effect and thus provides the clinically bilateral cleft lip repair has more beautiful,practical and feasible operation method.