16例新生儿唇裂修复的回顾

目的　通过对 16例新生儿唇裂修复的回顾 ,评价新生儿时期唇裂修复术的优缺点。方法　根据近 5年的临床资料 ,选择两组唇裂患儿 ,分别为新生儿唇裂修复术组和 3个月时手术组 ,每组16例 ,两组患儿的畸形类型和手术条件尽可能相互匹配 ,通过随访比较手术效果 ,并对其家属进行问卷调查。结果　两组患儿均能很好地耐受手术 ,但新生儿手术组有两例术后复裂。手术切口瘢痕两组差异不明显。调查显示 ,两组患儿家属在患儿出生时都求医迫切 ;对术后效果的满意度 3个月时手术组稍高 ,为 86.7% ,新生儿组为 71.4% ,P >0 .0 5;新生儿手术组已有 42 .9%接受再次矫正术 ,而 3个月时手术组仅为 6.7% ,P <0 .0 5。结论　新生儿唇裂修复术可尽早消除畸形 ,缓解患儿家属的心理压力 ,但对术者的操作技能要求较高

Repair of neonatal cleft lip: a study of 16 cases

Objective A tendency has been prevalence that the opera ti on of the cleft lip repair could be performed as early as possible now. Many neo nates who had a cleft lip have had a repair operation in their early days. In th is paper we designed a case-matched study on repair of cleft lip in neonate and 3-month-old infant to investigate the pros and cons of neonatal cleft lip repa ir. Methods The clinical data of cases with cleft lip repair th at we performed in recent 5 years were reviewed, and the patients were divided i nto 2 groups: neonatal group and 3-month-old infant group. Each group included 16 cases, which matched to each other, respectively. The results of the operati on between the 2 groups were compared. The questionnaires were sent to their par ents, and then the feedback information was statistically analyzed. Resu lts All the patients of the two groups were well survived during the op eration. Unfortunately, two patients in the neonatal group suffered from the avu lsion of the incision. The incision scar of the neonatal group was as same as th at of the 3-month-old infant group. There were no significant differences betwe en two groups on the anxious affection of family member when the patient was bor n ( P > 0.05 ). The parents of the second group were more satisfacted with the results of the repair operation than those of the first group ( the satisfac tory rates, 86.7 % and 71.4 %, respectively) ( P> 0.05). Only 42.9 % parents in neonatal group and 33.3 % in 3-month-old infant group considered that they were informed the knowledge about the cleft lip care from obstetricians, kin, o r from other routes ( P >0.05). The rates of second cheiloplasty had signific ant difference between 2 groups (42.9 % in neonatal group and 6.7 % in 3-month -old infant group)( P <0.05). Conclusions Neonatal cleft li p repair can be taken if the operation performer has a good understanding of it. It can effectively diminish the nervous stress that the parents suffered as ear ly as possible. But it may cause more severe secondary deformities in 3-month- old infant repair. There is no evidence that less incision scar will be resulted from neonatal cleft lip repair.