超声评估腭裂患儿舌运动的临床价值

Clinical value of ultrasonic assessment of tongue movement in children with cleft palate

目的应用超声观察单纯性腭裂患儿行修补术前使用矫形板对其舌位变化及舌背运动的影响,并探讨其评估患儿语言功能的应用价值。方法选择拟行腭裂修补术的单纯腭裂患儿36例,于术前按是否早期使用矫形板分为使用矫形板组和未使用矫形板组,各18例;另选同龄健康幼儿18例作为正常对照组;通过超声检测修补术前后两组患儿在发音过程中OA距离和AOB角度,并与正常对照组进行比较;同时对两组患儿手术前后发音清晰度进行评估。结果术前使用矫形板组、未使用矫形板组OA距离分别为(3.61±0.15)cm、(3.53±0.34)cm,均显著低于正常对照组(4.18±0.16)cm;AOB角度分别为(34°±5°)、(32°±4°),均显著高于正常对照组(20°±1°),差异均有统计学意义(均P<0.05);使用矫形板组和未使用矫形板组术后OA距离均较术前升高,AOB角度均较术前降低,且差异有统计学意义(均P<0.05);使用矫形板组术前获得良好发音的比例(17/18)显著高于未使用过矫形板组(11/18),差异有统计学意义(P<0.05)。结论超声可作为评估单纯性腭裂患儿舌头不规则运动及术后发音功能的一种有效手段;矫形板在腭裂修补术前的使用对患儿术后获得良好发音有着积极有效的应用价值。

Objective To investigate the value of ultrasound in assessing the impact of preoperative use of an orthopedic plate（OP）in improving pronunciation of children with cleft palate.Methods Ultrasonography was performed on 36 surgery treated children with cleft palate.Orthopedic plate was used in 18 cases（OP group）,while not used in the other 18 cases（NOP group）.AO value and AOB value were recorded before and after the operation and compared with 18 healthy children.Simultaneously,speech outcome of OP group and NOP group were evaluated before and after operation.Results Before operation,AO value of OP group[（3.61±0.15）cm]and NOP group[（3.53±0.34）cm]were significantly lower than that of healthy children[（4.18±0.16）cm],and AOB value（34°±5°,32°±4°）was obviously higher than that of healthy children（20°±1°）,there were significant difference（all P〈0.05）.After operation,AO value was increased,AOB value was decreased compared with pre-operation values,and the difference was statistically significant（all P〈0.05）.At the same time,preoperative use of OP group had a significantly higher percentage of good pronunciation than never use of OP group（17/18 vs. 11/18）,there was significant difference（P〈0.05）.Conclusion Ultrasound can be used as an effective method to evaluate the irregular tongue movement and postoperative articulation function in children with simple cleft palate.