先天性唇腭裂的围手术期护理

目的探讨先天性唇腭裂患者围手术期的有效护理方法。方法对300例唇腭裂患者围手术期,针对性实施有效的护理措施。结果295例患者对治疗效果满意,治愈率达到98．3％,无死亡病例。结论做好心理护理和临床护理,指导合理的饮食及加强监护是治疗成功的有力保障。     

The nasopharynx and the middle ear. Inflammatory reactions in middle ear disease

The host-parasite interactions in the nasopharynx with bacterial colonization and antigen uptake in the lymphoid tissue, the adenoid, has an impact on the maturation of local and systemic immunity. The adenoid is a part of mucosa associated lymphoid tissue and is responsible for both effector and inductor functions in the nasopharynx. Increasing evidence supports the role of serum antibody in protecting the middle ear cavity from disease. There is evidence for a minor immunologic defect in a number of children with recurrent episodes of AOM.     

Nutrition of children with cleft lip and cleft palate, a bibliographic study

The present study aimed at describing the children with congenital lip-palate malformation, emphasizing their alimentation, such as the difficulties and alternative methods to feed these children and nursing care in this process. The bibliographic review showed that there are many aspects in the alimentation care to fissured children, involving complex affective, social, economic and cultural relations that influence in mother-child relationship, in social discrimination of the fissured children and in mothers' difficulty to feed and give care to the child. Authors found the need to implement breast feeding, pointing out the physiological, psychological and social limitations that involve the child and the family as well as the importance of alimentation to physical and emotional development, favouring the surgical correction of lips and/or palate fissures as well as the rehabilitation process.     

腭裂术后腭前瘘防治措施的初步探讨

目的 探讨腭裂术后腭前瘘的防治措施.方法 对于23例完全性腭裂伴牙槽嵴裂患者,采用两瓣后退术式时,两侧黏骨膜瓣尽量前移,封闭硬腭前端腔隙,于软硬腭交界处切开,交界处创面以颊肌黏膜瓣覆盖,延长软腭,观察术后腭前瘘发生率及腭咽闭合情况.结果 23例患者,采用以上术式,术后1个月复查,无一例腭前瘘并发症出现,10例术后1年鼻咽镜检查腭咽闭合90%～100%,6例随访6个月,腭咽闭合80%～85%.结论 在一期手术中采取措施避免腭前瘘的发生或尽量缩小瘘口,减少二期手术几率或降低难度,减轻患者痛苦,不失为一种较好的预防措施.

Abstract：

Objective To discuss the preventive measures of anterior palatal fistula by modified the operation of cleft palate. Methods For 23 patients of complete cleft palate with alveolar ridge cleft, bilateral mucoperiosteum flap was moved forward as possible so as to close fistula front of hard palate, and incised junction of the hard and soft palate to prolong soft palate and the wound was repaired by buccal mucosal flap.The incidence of anterior palatal fistula and velopharyngeal closure after operation was observed. Results Twenty-three patients were rechecked 1 month after operation ,there was no anterior palatal fistula occurring,10 cases were examined by epipharyngoscope 1 year after operation,the velopharyngeal closure was 90%-100%. Six cases were followed up for 6 months,the velopharyngeal closure was 80%-85%. Conclusions For second-stage operation methods of anterior palatal fistula, there are too many discussions of selection criterias, advantages and disadvantages. If first-stage operation is taken measures to prevent anterior palatal fistula or decrease the diameter of fistula as possible. It reduces percentage of second-stage operation or decreases the difficulty. It should get more attention in the clinical works.     

Epidemiology of cleft palate alone and cleft palate with accompanying defects

The epidemiology of cleft palate with multiple defects is often thought to be different from that of cleft palate alone, but there are few empirical data on this question. We explored this in a population-based data set created by combining data from two sources: the 1.8 million live births recorded from 1967 to 1998 in the Norwegian Birth Registry, and the two Norwegian surgical centers that repair cleft palate. Accompanying defects were identified from either source. Stratified analysis and logistic regression were used to assess relative risks by covariates. Of 1,431 babies with cleft palate, 31 % had another birth defect recorded by one or both sources. Prevalence of isolated cleft palate was steady over time, while cleft palate with other defects increased substantially. Girls had a higher risk of isolated cleft palate (relative risk 1.4; 95% confidence interval, 1.2–1.6) but not of cleft palate accompanied by other defects (1.1; 0.88–1.3). Older parents and parents who were first cousins had no increased risk of isolated cleft palate, but were twice as likely as others to have a baby with cleft palate accompanied by other defects. Risk factors differ between cases of cleft palate with and without accompanying defects.     

幼儿期腭裂整复术的临床评价

目的探讨先天性腭裂幼儿期手术的安全性及其临床效果。方法对163例先天性腭裂患儿采用气管插管全麻下行腭裂整复术，根据不同腭裂类型选择不同的术式，观察其术中、术后情况，并对110例术后2～5年的患儿进行随访，初步评价语音效果。结果全部患儿都能很好地耐受麻醉及手术，无严重并发症发生。155例伤口愈合良好，8例术后穿孔。语音评价优良率达93．6％。结论掌握好适应证，幼儿期腭裂整复术是安全可行的，早期手术可使患儿语音恢复或明显改善。     

幼儿期腭裂整复术的临床评价

目的 探讨先天性腭裂幼儿期手术的安全性及其临床效果.方法 对163例先天性腭裂患儿采用气管插管全麻下行腭裂整复术,根据不同腭裂类型选择不同的术式,观察其术中、术后情况,并对110例术后2～5年的患儿进行随访,初步评价语音效果.结果 全部患儿都能很好地耐受麻醉及手术,无严重并发症发生.155例伤口愈合良好,8例术后穿孔.语音评价优良率达93.6%.结论 掌握好适应证,幼儿期腭裂整复术是安全可行的,早期手术可使患儿语音恢复或明显改善.     

Tympanometry in middle ear disease.

Tympanometry is an objective procedure which can aid in the identification of middle ear disease and eustachian tube dysfunction. This paper reviews its rationale, operation, and applications. The test procedure is simple and can be performed by trained personnel. The test is valid and reliable and can be used with children without discomfort. The results of tympanometry are quantifiable, recordable, and easy to interpret. The routine use of tympanometry in the family physician's office would offer a valuable tool in the identification and management of middle ear problems.     

总唇裂发生率变化趋势分析

目的:了解贵州省1996~2003年总唇裂的流行病学特征及发生率的动态变化趋势。方法:采用以医院为单位的整群抽样方法,对贵州省17所医院孕28周至产后7天的围产儿及191例总唇裂病例进行回顾性分析。结果:总唇裂发生率为20.79/万,其中单纯性唇裂为6.64/万,唇裂合并腭裂为14.15/万,单纯性唇裂有升高趋势。城乡总唇裂的发生率(20.23/万、24.41/万)无明显差异;男性发生率为25.36/万,女性为15.70/万,性别比为1.81∶1。不同年龄组产妇间唇裂合并腭裂的发生率有显著性差异,并随产妇年龄增加有升高趋势。结论:1996~2003年贵州省总唇裂发生率无变化,城乡无差异,男性易感性大于女性;唇裂合并腭裂较常见,且产妇年龄对其有影响。     

Parents' response to recurrent middle ear infection in their children

Recurrent ear infection in children during pre-school years is an important public health problem. Common advice given to parents is to minimize exposure of susceptible children to crowding and air pollution. This study aimed at investigating what changes parents undertake to improve the health of an otitis-prone child. Parents of children with greater than or equal to 5 events before age thirty months (index children; n = 198) and a matched control group (n = 396) were asked to fill in a questionnaire. Results show that 22.3% of index-families and 9.5% (p less than 0.001) of control families had changed one or more of the following conditions: working hours, child day-care, housing and smoking habits. In summary, index families and control families were remarkably similar given the striking difference in otitis media, a finding that rises concern.