CAJ | 학술논문

目的设计一种新的唇裂修复的手术方法,旨在减少术中组织损失,有效下降患侧唇峰,并使手术瘢痕更加符合人中嵴形态,且更有利于鼻尖的上抬和鼻底的成形.方法唇裂修复分鼻尖、鼻底和唇部三个区域分别完成.健侧白唇区域设计三叶形皮瓣.上方二皮瓣梯次向鼻小柱外侧和鼻底旋转,分别用于修复鼻尖上抬后鼻小柱旁的组织缺损,并重建鼻底区鼻堤结构,剩余的下方皮瓣向患侧不加旋转而直接推进,与患侧皮瓣直接缝合,在下降唇峰并恢复患侧人中嵴形态的同时,使手术的切口瘢痕与健侧人中平行,形态更接近自然.结果本组48例患者伤口均一期愈合,未发生任何血运障碍.唇峰下降满意,鼻底丰满度良好,鼻堤结构成形满意,同时鼻尖形态恢复较好,鼻孔横置现象得到明显改善,人中嵴形态良好.结论应用三叶瓣术式可避免以往唇裂修复术唇峰下降不足或白唇附加切口的缺陷,无需三角瓣的补充.术中同时恢复鼻尖高度并得到足够的鼻底组织量和良好鼻堤形态,术后切口瘢痕与对侧人中嵴对称.
목적 설계일충신적진렬수복적수술방법,지재감소술중조직손실,유효하강환측진봉,병사수술반흔경가부합인중척형태,차경유리우비첨적상태화비저적성형.방법 진렬수복분비첨、비저화진부삼개구역분별완성.건측백진구역설계삼협형피판.상방이피판제차향비소주외측화비저선전,분별용우수복비첨상태후비소주방적조직결손,병중건비저구비제결구,잉여적하방피판향환측불가선전이직접추진,여환측피판직접봉합,재하강진봉병회복환측인중척형태적동시,사수술적절구반흔여건측인중평행,형태경접근자연.결과 본조48례환자상구균일기유합,미발생임하혈운장애.진봉하강만의,비저봉만도량호,비제결구성형만의,동시비첨형태회복교호,비공횡치현상득도명현개선,인중척형태량호.결론 응용삼협판술식가피면이왕진렬수복술진봉하강불족혹백진부가절구적결함,무수삼각판적보충.술중동시회복비첨고도병득도족구적비저조직량화량호비제형태,술후절구반흔여대측인중척대칭.
Objective To develop a new method for reparation of cleft lip, and to evoke more colleagues for advance practices and study, in order to determine her indication and contraindication as soon as possible. Methods 48 cases were included into this study. Trilobate flap were Designed in floor of nose and lip area in cleft side, rotate two of the three flaps upwards, rspectively to elevate the tip of nose, and to reconstruct the floor of nose. As for the left flap, it was drived transversally to opposing side, sutured with the flap of non-cleftside. Results With this technique, less tissue was lost, better vertical lengthening and good formed cupids-bow was achieved, and the sear was a parallel line being symmetry to the philtrum column opposide. Meanwhile, because the tension was mainly located in the area where there was no mini flaps, the blood supply was good enough, rarely occur any necrosis in the tip of flaps. All cases in this study obtained perfect healing, with good appearance at nostrils and floor of nose. Conclusions In use of the method of trilobate flap, we can draw down the peak of the cupids bow effectually, hence avoid the addition cut in the lower part of the lip, decrease the scar on skin, as well as nice reconstruction of floor of nose, philtrum column and nostril. Because lack of long term study, we evoke more colleagues for cooperation in advance study.