本文選題：唇裂 + 鼻畸形矯正��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:觀察單側(cè)完全性唇裂與單側(cè)不完全性唇裂患兒行唇裂鼻畸形一期矯治術(shù),統(tǒng)一采用Noordhoff唇裂術(shù)式,并在術(shù)后半年佩戴鼻撐矯治鼻畸形,研究鼻撐對不同唇裂鼻畸形一期整復(fù)術(shù)后半年鼻軟組織形態(tài)恢復(fù)效果,為臨床治療不同唇裂鼻畸形提供參考并為術(shù)后二期鼻畸形整復(fù)提供有利條件[1-3]。方法:選取2012年1月-2016年10月就診于山西醫(yī)科大學(xué)第一醫(yī)院3到6個月不同單側(cè)唇裂患兒40例,男22例,女18例,平均年齡4.5±0.5個月。隨機(jī)分為四個實驗組,組一:單側(cè)不完全性唇裂一期鼻畸形整復(fù)術(shù)+術(shù)后鼻撐矯治半年。組二:單側(cè)不完全性唇裂一期鼻畸形整復(fù)術(shù)。組三:單側(cè)完全性唇裂一期鼻畸形整復(fù)術(shù)+術(shù)后鼻撐矯治半年。組四:單側(cè)完全性唇裂一期鼻畸形矯治術(shù)。對實驗組患兒術(shù)后半年拍攝數(shù)碼照片進(jìn)行客觀評價[4-6]。結(jié)果:通過測量鼻部軟組織相關(guān)指標(biāo)的非對稱率與角度指標(biāo)并應(yīng)用Spss20.0軟件進(jìn)行統(tǒng)計分析后得出,四組差異有統(tǒng)計學(xué)意義[p〈0.05]。1、在組二與組四對比中發(fā)現(xiàn),不同唇裂患兒在施行同一唇裂術(shù)式的情況下,單側(cè)不完全性唇裂患兒在鼻孔高度、鼻孔寬度、鼻翼厚度、鼻翼突出距、鼻孔周長與面積的非對稱率與單側(cè)完全性唇裂患兒組相比,差異有統(tǒng)計學(xué)意義[p〈0.05]。鼻翼外展角,鼻小柱傾斜角,鼻底傾斜角較單側(cè)完全性患兒組小,說明術(shù)后患兒鼻部形態(tài)的恢復(fù)與唇裂鼻畸形的程度相關(guān)。2、在組一與組二和組三與組四的對比中發(fā)現(xiàn),同一分型的單側(cè)唇裂患兒在相同術(shù)式條件下,佩戴鼻撐組患兒在鼻孔高度、鼻孔寬度、鼻翼厚度、鼻翼突出距的非對稱率與對照組差異有統(tǒng)計學(xué)意義[p〈0.05]。鼻翼外展角,鼻小柱傾斜角,鼻底傾斜角較不佩戴組小,說明鼻撐在一期鼻畸形整復(fù)術(shù)后對鼻軟組織形態(tài)的維持與恢復(fù)具有重要的臨床意義,也為鼻畸形二期整復(fù)提供良好的手術(shù)條件。結(jié)論:不同單側(cè)唇裂患兒在一期進(jìn)行鼻畸形手術(shù),術(shù)后通過積極佩戴鼻撐作為鼻畸形矯正術(shù)后的輔助性矯治措施,對于輔助及引導(dǎo)鼻正常生長發(fā)育具有重要的臨床意義。同時為鼻畸形二期手術(shù)創(chuàng)造良好的條件,減少二期手術(shù)難度。
[Abstract]:Objective: to observe the primary correction of cleft lip nasal deformity in children with unilateral complete cleft lip and incomplete cleft lip, using Noordhoff cleft lip procedure and wearing nasal brace to correct nasal deformity half a year after operation. To study the effect of nasal bracing on the recovery of nasal soft tissue morphology half a year after primary repair of different cleft lip nose deformities, to provide references for clinical treatment of different cleft lip nose deformities and to provide favorable conditions for secondary nasal deformities after operation [1-3]. Methods: from January 2012 to October 2016, 40 children (22 males and 18 females) with different unilateral cleft lip were enrolled in the first Hospital of Shanxi Medical University from 3 to 6 months. The average age was 4.5 鹵0.5 months. The patients were randomly divided into four experimental groups. Group 1: unilateral incomplete cleft lip one-stage nasal deformity was repaired for half a year after nasal bracing. Group 2: unilateral incomplete cleft lip one-stage nasal deformity. Group 3: unilateral complete cleft lip one-stage nasal deformities were repaired for half a year after nasal bracing. Group 4: unilateral complete cleft lip one-stage nasal deformity correction. Objective evaluation was made on the digital photographs taken half a year after operation in the experimental group [4-6]. Results: the asymmetry rate and angle index of nasal soft tissue were measured and analyzed by SPSS 20.0 software. The results showed that the difference among the four groups was statistically significant [p < 0.05] .1, which was found in the comparison of group two and group four. Under the same cleft lip operation mode, the patients with unilateral incomplete cleft lip had nostril height, nostril width, thickness of nasal wing, distance of nasal wing protrusion. The asymmetric rate of nostril circumference and area was significantly different from that of unilateral complete cleft lip group [p < 0.05]. The alar abduction angle, nasal column angle, and nasal floor angle were smaller than those in the unilateral complete group, indicating that the recovery of nasal morphology was related to the degree of cleft lip nasal deformity, which was found in the comparison between group 1 and group 2 and group 3 and group 4. In the same type of unilateral cleft lip, the asymmetric rate of nasal height, width, thickness of nasal wing and distance between the two groups were significantly different from those in the control group (p < 0.05). The alar abduction angle, nasal column angle, and nasal floor angle were smaller than those in the non-wearing group, which indicated that nasal bracing had important clinical significance for the maintenance and recovery of nasal soft tissue morphology after primary nasal deformity reduction. It also provides good surgical conditions for the second stage reduction of nasal deformity. Conclusion: children with different unilateral cleft lip underwent nasal deformity surgery in one stage. It is of great clinical significance to assist and guide the normal growth and development of nose by actively wearing nasal braces as auxiliary correction measures after nasal deformity correction. At the same time, good conditions were created for the second stage operation of nasal deformity and the difficulty of the second stage operation was reduced.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R782.21

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 畢思思;李錦峰;任戰(zhàn)平;陶永煒;郭彥;;單側(cè)完全性唇裂患兒一期鼻畸形整復(fù)的臨床研究[J];中國美容醫(yī)學(xué);2015年10期

2 劉思洋;葉曼;羅莎;;單側(cè)完全性唇裂同期鼻整形聯(lián)合鼻撐矯形效果評價[J];中國醫(yī)藥導(dǎo)報;2014年24期

3 時春華;孫素珍;袁文鈞;;術(shù)前鼻-牙槽塑形矯治器矯治對單側(cè)完全性唇腭裂的影響[J];浙江實用醫(yī)學(xué);2014年03期

4 王濤;封興華;張浚睿;吳國峰;畢云鵬;魏建華;;三維掃描技術(shù)對單側(cè)完全性唇裂同期鼻整形并行鼻撐矯形的效果分析[J];中國美容醫(yī)學(xué);2011年12期

5 楊繼英;聶國輝;梁志剛;鄭蒼尚;齊莉;;心理指導(dǎo)在腭裂患兒術(shù)后語音治療中的作用[J];口腔醫(yī)學(xué)研究;2009年06期

6 楊增杰;陳仁吉;穆s，

本文編號：2023892