唇裂术后鼻部对称性的变化及其影响因素

摘要

Objective To evaluate the symmetry rate of nasal floor width and the influencing factor for the unilateral complete cleft lip (UCCL) after repair with Huaxi technique. Methods 27 UCCL patients repaired with Huaxi technique were photographed before repair, 1 week and 1 year after surgery. The distance from columella point to facial midline, the nasal floor width and the fissure width were measured. The approach rate of the columella point,the symmetry rate and the change of the nasal floor width were calculated. The statistical analysis was completed by SPSS 13.0. Results There was statistical difference of the approach rate for the columella point between 1 week and 1 year after surgery(54.06％, 63.96％; P＜0.05), no statistical difference was found of the symmetry rate for the nasal floor between 1 week and 1 year after surgery(69.12％, 75.93％; P＞0.05). There was statistical difference of the change for nasal floor width between the cleft side and the non-cleft side in a week (P=0.000), but no statistical difference was found in a year (P=0.262). The linear correlation was obtained between the distance from columella point to facial midline 1 week after surgery and the distance from columella point to facial midline(r=0.465, P=0.014) and the fissure width (r=0.486, P=0.010) before surgery. No linear correlation was obtained between other index after surgery and before surgery (P＞0.05). Conclusion The symmetry rate of nasal floor width is stable after surgery with Huaxi technique, and the growth changes have not significant impact on the effect of the surgery in a short-term.%目的 评价华西法修复单侧完全性唇裂术后鼻底宽度及其对称性的变化以及与裂隙宽度的关系,为一期手术鼻畸形整复提供参考.方法选择应用华西法修复单侧完全性唇裂患者27例,分别于术前、术后1周及术后1年拍摄面部正位照片,测量鼻小柱中点偏离程度、鼻底宽度及裂隙宽度,计算鼻小柱中点回归率、鼻底宽度对称率和鼻底宽度变化,并采用SPSS 13.0软件进行统计分析.结果 术后1周同术后1年相比,鼻小柱中点回归率(54.06%,63.96%)有统计学差异(P＜0.05),鼻底宽度对称率(69.12%,75.93%)无统计学差异(P＞0.05).健侧的1周鼻底宽度变化与患侧相比有统计学差异(P=0.000),而1年鼻底宽度变化与患侧相比无统计学差异(P=0.262).术后1周的鼻小柱中点偏离程度与术前的裂隙宽度(r=0.486,P=0.010)、鼻小柱中点偏离程度(r=0.465,P=0.014)存在着相关关系,而其他术后指标与术前各项指标均不存在相关关系(P＞0.05).结论 采用华西法修复单侧完全性唇裂,其鼻底宽度的对称性较为稳定,术后短期内的生长变化对手术效果没有明显影响.