CAJ | 학술논문

目的探讨前唇长度不足的完全性双侧唇裂畸形的有效修复方法.方法选择双侧完全性唇裂死婴新尸体2例,经氧化铅动脉灌注造影后,取鼻唇部组织拍X线片,了解其血供特点.临床上选择前唇长度明显不足的完全性双侧唇裂16例,利用其前唇血供特点,在鼻唇部做V形切口,使鼻小柱与前唇充分分离,形成近似带血管蒂的岛状前唇组织瓣,前唇便很容易下降到与侧唇对应的位置,解决了前唇长度不足的难点.然后,按照Millard的术式修复双侧唇裂.1年余后拍摄患者正、侧头位面像,在照片上测量鼻唇面各解剖标志点之间线性距离及角度,并与对照组30例正常婴幼儿比较,客观地评估手术效果及稳定性.结果双侧完全性唇裂的前唇血供主要由鼻中隔后动脉供应.16例双侧唇裂患儿术后1年,上唇形态良好,测量的各项指数统计学处理显示:多数与正常婴幼儿对照组差异无统计学意义,客观上提示手术效果满意.结论利用双侧唇裂患者前唇血供主要由鼻中隔后动脉供应的解剖特点,修复完全性双侧唇裂,可以有效地解决前唇过短的难题,术后效果理想、稳定.
목적 탐토전진장도불족적완전성쌍측진렬기형적유효수복방법.방법 선택쌍측완전성진렬사영신시체2례,경양화연동맥관주조영후,취비진부조직박X선편,료해기혈공특점.림상상선택전진장도명현불족적완전성쌍측진렬16례,이용기전진혈공특점,재비진부주V형절구,사비소주여전진충분분리,형성근사대혈관체적도상전진조직판,전진편흔용역하강도여측진대응적위치,해결료전진장도불족적난점.연후,안조Millard적술식수복쌍측진렬.1년여후박섭환자정、측두위면상,재조편상측량비진면각해부표지점지간선성거리급각도,병여대조조30례정상영유인비교,객관지평고수술효과급은정성.결과 쌍측완전성진렬적전진혈공주요유비중격후동맥공응.16례쌍측진렬환인술후1년,상진형태량호,측량적각항지수통계학처리현시:다수여정상영유인대조조차이무통계학의의,객관상제시수술효과만의.결론 이용쌍측진렬환자전진혈공주요유비중격후동맥공응적해부특점,수복완전성쌍측진렬,가이유효지해결전진과단적난제,술후효과이상、은정.
Objective To develop a new method for correction of the deformity of the complete bilateral cleft lip with short pre-lip. Methods Two specimens with the complete bilateral cleft lip was chosen to investigate the arterial supply to the pre-lip. The arteries were observed by radiography when the specimen was infused with lead oxide. 16 patients with the complete bilateral cleft lip and shortage in the length of pre-lip were enrolled in this study. Taking advantage of the unique character of arterial supply of complete bilateral cleft lip, those with short pre-lip were corrected. Photos of them were taken when preand post-operation for further measurement. And more than 1 year following-up was conducted to judge if the results were good enough or not. 30 babies were chosen as a control group to confirm the results of surgury objectively. Results Post nasal septal arteries were found to supply the pre-lip of the bilateral complete cleft lip. Appearance of 16 patients was good after surgery or 1 years later. There was no statistical significant difference between the patients and control group in the measurement data but nasal-lip angle. Conclusion It is an effective way to correct deformity of the bilateral cleft lip with short pre-lip by taking advantage of post nasal septal arterie's flap.