婴儿期唇腭裂同期手术修复的临床探讨

目的探讨婴儿期唇腭裂同期手术的临床效果。方法对158例唇腭裂患儿在全麻气管插管麻醉下,采用唇腭裂同期手术修复,观察术中、术后情况,对手术方法、预后及并发症进行观察。结果 158例患儿均能耐受唇腭裂同期手术、麻醉,16例输悬浮红细胞0.5~1u;喉头水肿12例（7.6%）,肺炎21例（13.3%）,腹泻15例（9.4%）,术后高热超过3 d的5例（3.1%）;悬雍垂裂开13例（8.2%）,软硬腭交界处瘘12例（7.5%）,牙槽嵴瘘9例（5.7%）;儿能耐受麻醉、手术,术中出血少,术后无明显感染征象,不适反应少,语音功能恢复好,无明显并发症发生。结论掌握好适应症,有麻醉、手术、护理、急救条件时,婴儿期行唇腭裂同期修复手术是安全、可行的,具有明显优势。

Clinical Experience of the Cleft Lip Operation Concurrent with Cleft Palate Surgery in Infancy

Objective To investigate the clinical effects of infant cleft lip and palate surgery in the same period. Methods 158 children with cleft lip and palate were repaired by cleft lip and palate surgery during the same period under general anesthesia with tracheal intubation. The intraoperative and postoperative condition, surgical methods, outcomes and complications were ob- served. Results All the 158 cases could tolerate the cleft lip and palate surgery during the same period and the anesthesia. There were 16 cases with the transfusion of suspended red blood cells 0.5-1u, 12 cases with laryngeal edema（7.6%）, 21 cases with pneu- monia（13.3%）, 15 cases with diarrhea（9.4%）, 5 cases with postoperative fever over 3 days （3.1%）, 13 cases with uvula dehiscence （8.2%）, 12 cases with fistula at the junction of soft and hard palate（7.5%）, 9 cases with alveolar fistula（5.7%）. The children can tol- erate the anesthesia, surgery with less bleeding and discomfort, the voice function recovered well, and no obvious complications and signs of infection after surgery. Conclusion Cleft lip operation concurrent with cleft palate surgery in infancy is safe and fea- sible with obvious advantages if the indications are mastered, and there are anesthesia, surgery, nursing and emergency conditions.