可吸收医用生物膜修复硬腭裂隙的临床应用

目的　探讨使用可吸收医用膜修复硬腭裂隙的可行性及评价其近期临床效果。方法　68例腭裂患者随机分为实验组和对照组。实验组34例患者在软腭及悬雍垂裂修复的同时剖开硬腭裂隙,植入可吸收医用膜修复; 对照组34例采用常规腭裂修复术。结果　实验组所有患者其软腭及悬雍垂创口愈合良好,无穿孔与裂开;硬腭部创口一期愈合30例,二期愈合3例,1例遗留永久性的口鼻瘘,3例存在口腔前庭瘘。与对照组相比较,其出血量及口腔前庭瘘发生率减少,手术时间无明显延长,术后出血、呼吸困难等并发症无明显增加;术后体温多波动在 37·5℃以下,且逐渐降低,7 d后复查血常规与对照组相比无显著异常。结论　可吸收医用膜用于硬腭裂隙修复, 临床效果肯定且手术操作简单、可行,同时因避免了常规腭裂修复术时在硬腭部掀起粘骨膜瓣的缺点,可减少对颌骨发育的影响。

Repair of Hard Cleft Palate with Absorbable Membranes Made by Poly-DL-Lactic Acid:A Feasibility Study

Objective To investigate the feasibility and clinical results of applying poly-DL-lactic acid (PDLLA) biomembranes in cleft palate repair.Methods 68 cleft palate patients were divided into study group and control group. The traditional surgical method was used to control group to close the soft cleft palate, and the PDLLA biomembrane was used to study group and implanted into the surgical gap between the periosteum and bone at the hard palate, and fixed with suture. The duration, blood loss at operation, post-operative complication, wound healing and recovery were recorded and compared to conventional cleft palate repair.Results Operations were successfully completed on all 34 patients. Wound healing of soft palate and uvula was uneventful with no incidence of fistula or dehiscence. The primary healing on tissue defect of hard palate occurred in 29 patients, secondary healing occurred in 3 patients, permanent fistula between the oral cavity and the nasal cavity occurred in only one patients, and 3 patients left over fistula on alveolar process. Compared to traditional cleft palate repair, blood loss and incidence of fistula on alveolar process were decreased; the average surgical time was 89.25 minutes and was not prolonged; and there was no significant increase in post-operative complication.Conclusion Hard cleft palate repair with PDLLA biomembranes is safe, simple and practical with good clinical results and is beneficial to minimize the bad influences towards the development and growth for maxilla of cleft palate patients.