梯度旋转下降法治疗单侧完全性唇裂效果评价

目的：探讨梯度旋转下降法治疗单侧完全性唇裂术后鼻唇部对称性的改善程度及稳定性。方法：采用梯度旋转下降法修复30例左侧完全性唇裂患者,分别于术前、术后1周及术后1年采集照片,测量鼻唇部的相关指标,并使用配对t检验比较其对称性和稳定性,采用SPSS 19.0软件包对数据进行统计学分析。结果：术前鼻翼点、鼻翼基部点、唇峰点健、患侧之间有显著差异（P<0.05）;术后1周,鼻翼点、鼻翼基部点、口角点健、患侧之间有显著差异（P<0.05）,而唇峰点无显著差异（P>0.05）;术后1年,除鼻翼点（P<0.05）外,其余标志点健、患侧之间均无显著差异（P>0.05）。术后1周,各指标距面部中线的距离均小于术前。除鼻翼点外,其他标志点术后1周与术后1年的对称率差异无显著性（P>0.05）。结论：使用梯度旋转下降法修复单侧完全性唇裂,唇部的对称性恢复较为理想,且术后效果稳定;而鼻部对称性较差,但经过自我调整,1年后略有好转。

Evaluation of the symmetry in nasolabial area of unilateral complete cleft lip with the method of rotation descent step by step

PURPOSE:To evaluate the symmetry and stability of nasolabial area of unilateral complete cleft lip(UCCL) after primary repair with the method of rotation descent step by step.METHODS:Thirty patients with UCCL who were operated on were photographed before,1 week after and 1 year after surgery,the distances from alare point(al),sub alare point(sba),christa phlitri point(cph)and chelion point(ch)to the facial vertical midline(VML)were measured and compared with the opposite side by paired t test.Statistical analysis was performed with SPSS 19.0 software package.RESULTS:There were significant differences in al,sba and cph between the cleft side and non-cleft side before(P<0.05)and 1 week after surgery;significant differences were found in al,sba and ch between the affected and unaffected side(P<0.05);but 1 year after surgery,there was no significant difference between the two sides except sba.After surgery,all the distances from VML were less than those before surgery.There was no significant difference in symmetry rate between 1 week and 1 year after surgery for all the points except sba.CONCLUSIONS:The results indicated that the method of rotation descent step by step is very helpful in reconstruction of lip symmetry,but primary repair can not achieve full recovery of nasal symmetry.