中菲两国及不同地区唇腭裂临床治疗的比较

目的:比较不同国家、地区唇腭裂治疗的现状,为基层医院规范开展唇腭裂治疗提供具有实用参考意义的理论依据。方法:分别对2007-02-2007-07,间菲律宾Davao市医疗中心(第一组)、中国兰州大学附属第一人民医院(第二组)和中国上海交通大学医学院唇腭裂治疗研究中心(第三组)住院手术的唇腭裂病例进行比较分析。第一组共200例,男133例,女67例;单侧唇裂150例,双侧唇裂48例,腭裂2例。年龄分布是:0～12个月53例,2～4岁85例,5～12岁52例,13～18岁4例,19～25岁4例,>26岁2例。第二组共160例,男85例,女75例;单侧唇裂54例,双侧唇裂7例,腭裂53例,唇裂二期17例,牙槽突裂植骨1例,腭瘘与复裂28例。年龄分布是:0～12个月10例,2～4岁56例,5～12岁58例,13～18岁23例,19～25岁8例,>26岁5例。第三组共300例,男175例,女125例;单侧唇裂36例,双侧唇裂16例,腭裂98例,唇裂二期36例,牙槽突裂植骨33例,面横裂、斜裂5例,腭瘘与复裂29例,咽成形术32例,腭心面12例,robin 3例。年龄分布:0～12个月72例,2～4岁90例,5～12岁52例,13～18岁43例,19～25岁42例,>26岁1例。结果:第一组以唇裂为主,且手术年龄普遍过大,唇裂术式以Millard为主,口轮匝肌的对位吻合为主流术式,但该组病例单一。第三组的手术年龄小于前2组,病种明显丰富于前2组。前2组唇裂术后上唇组织明显过紧。结论:唇腭裂是颌面部最常见的先天性畸形,也是目前全球各类慈善组织或基金会热衷服务的项目之一。开展的内容与所在医院的设施有密切的关系,手术的病种除与医院设施相关外,参与术者的操作技能起着不可忽视的作用,如何做好术后随访是该类手术有待加强的工作之一。

Comparison on the Reconstructive Therapy of Cleft Lip and Palate in Different Regions in China and the Philippines

Objective:To compare the treatment status of cleft lip and palate in areas of China and the Philippines. Methods:All patients had undergone operation from February to July 2007.The first group consisted of 200 cases in 3 hospitals from Davao Medical Center,in the Philippines,Male 133,female 67;UCL 150,BCL 48,CP 2.Age distribution:0～12m 53,2～4y 85,5～12y 52,13～18y 4,19～25y 4,>26y 2.The second group consisted of 160 cases from the first people's hospital affiliated to Lanzhou University,in China.Male 85,female 75;UCL 54,BCL 7,CP 53,nasolabial deformities 17, alveolar cleft 1,fistula of palate 28.Age distribution:0～12m 10,2～4y 56,5～12y 58,13～18y 23,19～25y 8,>26y 5.The 3rd group consisted of 300 eases from the Craniofacial Center affiliated to Shanghai Jiaotong University,in China.Male 175, female 125;UCL 36,BCL 16,CP 98,nasolabial deformities 36,alveolar cleft 33,facial cleft 5,fistula of palate 29, pharyngoplasty 32,VCFS 12,Robin sequence 3.Age distribution:0～12m 72,2～4y 90,5～12y 52,13～18y 43,19～25y 42,>26y 1.Results:The patient's age in group 1 were older than those of other two groups.The average age patients in group 3 was the reconstructive method in group 1 was mainly of Millard technique and accompanied with orbieularis otis muscle restoration.The restored width of the upper lip was not enough in the first two group patients.The diversity of patients in group 3 was the most.Conclusion:Cleft lip and palate malformations are popular in the field of oral and maxillofacial surgery.Their restorations are endorsed by charitable institutions and foundations worldwide.The outcome of restoration significantly correlated to the facilities of the hospital and the skills of the plastic surgeons.Also,A follow-up is critical.