唇裂术后效果评价研究进展

Progress in evaluating the postoperative effect of cleft lip

唇裂术后效果评价是改进手术方法、改善整复效果的重要手段。近年来,唇裂整复方法不断推陈出新,如华西式旋转推进法、唇鼻肌肉张力带重建+三叶瓣法等。但目前术后继发畸形问题仍然较多,如瘢痕明显、鼻翼塌陷等。本文通过回顾以往的文献,对现有的唇裂术后效果评价方法、优缺点及适用情况作一综述。迄今为止,已经有大量的方法可以用于唇裂术后效果评价,这些研究方法可以分为主观评价和客观评价两大类,如主观评价、直接测量、照片测量、三维扫描测量等。其中,主观评价操作简单,但可信度稍差,适用所有唇裂患者;直接测量成本低,仅适用于一维信息测量,但精确度稍差,标志点确定较为困难;照片测量耗时短,可避免组织变形,但易产生误差,适用于能配合的唇裂患者;三维扫描测量精度高、耗时短、操作简单,但费用高,适用于具有该设备条件的地区。总而言之,唇裂术后效果评价应主观评价和客观评价相结合、动态与静态评价相结合,并且要长期随访,以此获得全面、准确的信息,为临床医师开展唇裂手术工作提供参考依据。

The postoperative evaluation of cleft lip is an important means to improve the operation method and the effect of the restoration. In recent years, the methods of cleft lip repair, such as Chinese western rotary propulsion, reconstruction of labial and nasal muscle tension band + trefoil flap, etc., have been developed. However, at present, there are still many secondary deformities, such as obvious scars and alar collapse. In this paper, in a review of the previous literature, the existing methods, advantages and disadvantages, and the application of the evaluation of the postoperative effect of cleft lip were reviewed. To date, there are many methods that can be used to evaluate the effect of cleft lip surgery. These research methods can be divided into subjective evaluation and objective evaluation, such as subjective evaluation, direct measurement, photo measurement, and three-dimensional scanning measurement. Among them, the subjective evaluation is simple, but the reliability is poor, and this method is suitable for all patients with cleft lip. The direct measurement has a low cost and is only suitable for one-dimensional information measurement, but the accuracy is poor, so it is difficult to determine the endpoints. The time of the photo measurement method is short, which can avoid tissue deformation, but it is easy to produce errors;this method is suitable for patients with cleft lip who can cooperate. The three-dimensional scanning measurement has a high accuracy, is time consuming and is a simple method but has a high cost and is suitable for areas with appropriate equipment conditions. Overall, the evaluation of the postoperative effect of cleft lip surgery should combine subjective evaluation with objective evaluation, dynamic evaluation with static evaluation, and utilize long-term follow-up to obtain comprehensive and accurate information and provide a reference for clinicians to carry out cleft lip surgery.