单侧唇裂患儿行改良Mohler法修复的临床效果研究(1)
[摘要]目的：探讨改良Mohler法修复单侧唇裂的临床效果，为临床治疗提供参考。方法：选取笔者医院2015年1月-2018年6月就诊的70例单侧唇裂患儿，年龄3～17个月，平均(7.5±2.2)个月，均接受改良Mohler法修复，术后由颌面外科资深医师评估手术修复美观效果，并测量手术前后裂隙两侧唇长、唇高、人中嵴高度、鼻小柱基底等唇鼻外观形态参数。结果：70例单侧唇裂患儿均成功完成改良Mohler术，术后愈合较好，未出现感染、裂开等并发症。一期修复效果优良率为92.86%，双侧唇高/宽/长度、鼻底宽度、鼻孔大小等协调对称，5例修复欠佳者行二期修复，唇鼻形态逐渐恢复正常；术前健患侧唇长、唇高、鼻底宽度、鼻小柱高度、人中嵴高度比较，均有显著性差异，具有统计学意义(P<0.05)，术后1周拆线测量，健、患侧上述唇鼻外观形态参数比较，无显著性差异(P>0.05)。结论：改良Mohler法能有效修复单侧唇裂患儿的唇鼻外观形态，可作为临床治疗的参考方案。
[关键词]单侧唇裂；改良Mohler法；修复效果；口鼻形态
, 百拇医药
[中图分類号]R782.2+1 [文献标志码]A [文章编号]1008-6455(2018)12-0113-03
Clinical Effect of Modified Mohler Repair for 70 Children with Unilateral Cleft Lip
NI Jin-bing
(Department of Stomatology， Anhui Children's Hospital，Hefei 230051，Anhui，China)
Abstract： Objective To explore the clinical effect of modified Mohler in the repair of unilateral cleft lip， and provide reference for clinical treatment. Methods Seventy children with unilateral cleft lip， aged from 3 months to 17 months， with an average of (7.5±2.2) months， were selected from January 2015 to June 2018. All the patients were repaired by Mohler's method in our hospital. Senior surgeons of maxillofacial surgery evaluated the aesthetic effect of the operation. The appearance parameters of lip and nose， such as the length of lip， the height of middle ridge， the base of nasal columella， were measured before and after the operation. Results Modified Mohler procedure was successfully performed in 70 children with unilateral cleft lip. The postoperative healing was good without complications such as infection and cleft lip.The excellent and good rate of stage I repair was 92.86%. The height/width/length of bilateral lip， the width of nasal base and the size of nostril were coordinated and symmetrical. Five cases of poor repair underwent stage II repair， and the shape of lip and nose gradually returned to normal.There was no significant difference in the appearance parameters of lip and nose on the affected side (1W) after surgery (P>0.05). Conclusion Modified Mohler method can effectively repair the appearance of lip and nose in children with unilateral cleft lip， and can be used as a reference for clinical treatment.
, 百拇医药
Key words： unilateral cleft lip； modified Mohler method； repair effect； oral and nasal morphology
唇裂是口腔颌面部常见的先天性畸形，临床发病率约为1/1 000，以单侧唇裂最为常见。单侧唇裂可分为单侧不完全性唇裂和完全性唇裂，主要表现为上唇部不同程度(Ⅰ～Ⅲ度)裂开，不仅影响小儿外貌美观度，而且会引起进食困难、语音表达障碍，还易导致感染、引起中耳炎等系列问题，及时采取干预措施修复畸形尤为重要[1-2]。手术是修复单侧唇裂的有效手段，1955年，Millard提出的旋转推进皮瓣法修复术，能较好地修复唇鼻外形，一直被临床广泛采用，但旋转推进法也存在固有设计缺陷，比如过分倾斜的垂直瘢痕、唇上份横向瘢痕明显，手术修复美观效果难以令人满意，同时增加Ⅱ期修复的难度[3]。随着口腔颌面外科手术发展和旋转推进法的不断精细化改良，改良Mohler修复法的应用优势逐渐凸显[4]。但笔者通过文献索引，发现国内关于改良Mohler法的临床报道较少，手术经验总结更缺乏。笔者医院近3年行改良Mohler法修复了70例单侧唇裂患儿，修复效果满意，现将结果报道如下。, http://www.100md.com(倪进兵)
[关键词]单侧唇裂；改良Mohler法；修复效果；口鼻形态
, 百拇医药
[中图分類号]R782.2+1 [文献标志码]A [文章编号]1008-6455(2018)12-0113-03
Clinical Effect of Modified Mohler Repair for 70 Children with Unilateral Cleft Lip
NI Jin-bing
(Department of Stomatology， Anhui Children's Hospital，Hefei 230051，Anhui，China)
Abstract： Objective To explore the clinical effect of modified Mohler in the repair of unilateral cleft lip， and provide reference for clinical treatment. Methods Seventy children with unilateral cleft lip， aged from 3 months to 17 months， with an average of (7.5±2.2) months， were selected from January 2015 to June 2018. All the patients were repaired by Mohler's method in our hospital. Senior surgeons of maxillofacial surgery evaluated the aesthetic effect of the operation. The appearance parameters of lip and nose， such as the length of lip， the height of middle ridge， the base of nasal columella， were measured before and after the operation. Results Modified Mohler procedure was successfully performed in 70 children with unilateral cleft lip. The postoperative healing was good without complications such as infection and cleft lip.The excellent and good rate of stage I repair was 92.86%. The height/width/length of bilateral lip， the width of nasal base and the size of nostril were coordinated and symmetrical. Five cases of poor repair underwent stage II repair， and the shape of lip and nose gradually returned to normal.There was no significant difference in the appearance parameters of lip and nose on the affected side (1W) after surgery (P>0.05). Conclusion Modified Mohler method can effectively repair the appearance of lip and nose in children with unilateral cleft lip， and can be used as a reference for clinical treatment.
, 百拇医药
Key words： unilateral cleft lip； modified Mohler method； repair effect； oral and nasal morphology
唇裂是口腔颌面部常见的先天性畸形，临床发病率约为1/1 000，以单侧唇裂最为常见。单侧唇裂可分为单侧不完全性唇裂和完全性唇裂，主要表现为上唇部不同程度(Ⅰ～Ⅲ度)裂开，不仅影响小儿外貌美观度，而且会引起进食困难、语音表达障碍，还易导致感染、引起中耳炎等系列问题，及时采取干预措施修复畸形尤为重要[1-2]。手术是修复单侧唇裂的有效手段，1955年，Millard提出的旋转推进皮瓣法修复术，能较好地修复唇鼻外形，一直被临床广泛采用，但旋转推进法也存在固有设计缺陷，比如过分倾斜的垂直瘢痕、唇上份横向瘢痕明显，手术修复美观效果难以令人满意，同时增加Ⅱ期修复的难度[3]。随着口腔颌面外科手术发展和旋转推进法的不断精细化改良，改良Mohler修复法的应用优势逐渐凸显[4]。但笔者通过文献索引，发现国内关于改良Mohler法的临床报道较少，手术经验总结更缺乏。笔者医院近3年行改良Mohler法修复了70例单侧唇裂患儿，修复效果满意，现将结果报道如下。, http://www.100md.com(倪进兵)
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