婴儿唇腭裂同期修复468例临床分析

目的探讨唇腭裂在婴儿期同期修复的可行性及优缺点。方法回顾性分析我科近十年来同期修复婴儿期唇腭裂468例,对术后3年以上患者进行语音评价。结果468例婴儿均完成唇腭裂同期修复,术后出现并发症173例,死亡1例。其中94例出现不同程度呼吸困难,74例出现腭部缝合口裂开(63例为悬雍垂裂开),2例唇部切口感染,1例因术中缺氧出现脑瘫,2例出现恶性高热(其中1例死亡),1例拔出碘仿纱条后大出血。术后3年以上有278例,随访168例,发音优115例,良48例,差5例。结论婴儿期同时修复唇腭裂虽具有术后语音效果好及其他优点,但呼吸困难及悬雍垂裂开发生率高,良好的麻醉对保证手术成功至关重要。

Clinical analysis of cleft lip and palate repair at the same time on 468 infants

Objective To study the feasibility, merit and shortcoming of simultaneously repairing cleft lip and palate during the infancy. Methods 468 infants with cleft lip and palate repaired simultaneously in our department from 1995 to 2004 were reviewed retrospectively, as well as the cases repaired three years before were followed up and evaluated in pronunciation. Results 468 infants with cleft lip and palate were effectively treated simultaneously,associated with 173 had complications and 1 died after operation. 94 cases appeared dyspnea(20.1%),74 cases had ruptured incision in palate including 63 cases in uvula,2 cases infected in clip incision,1 case got paralytic brain for lack of oxygen during the anesthesia,2 cases ran malignant high fever including 1 dying of it,1 case bled excessively after iodoform gauze pulled out. Among the 168 cases followed up relative to 278 who had treated three years before, 115 cases got clear pronunciation,48 cases were next and 5 cases'pronunciation were unclear. Conclusions Repairing cleft lip and palate simultaneously during the infancy has high rates of dyspnea and ruptured incision in uvula, though which contributes to clear pronunciation and has other merits, and perfect anesthesia is important to success in operation.