CAJ | 학술논문

目的：研究2岁以上腭裂患者术后腭咽闭合功能的影响因素。方法对245例2岁以上腭裂患儿术后腭咽闭合功能和可能影响术后腭咽闭合功能的因素（腭咽比值、腭裂类型、手术年龄、术式）进行回顾性研究。结果腭咽闭合不全（VPI）组和腭咽闭合完全（VPC）组术前相对裂隙宽度、腭咽比值差异无统计学意义。不同年龄组、不同腭裂类型术后腭咽闭合率未见明显差异。不同的术式术后腭咽闭合率差异有统计学意义。结论大年龄腭裂患者的治疗不宜照搬2岁以下患儿单纯行腭裂整复术的常规治疗方案。裂隙的大小不是影响大年龄腭裂患者术后腭咽闭合功能的主要因素。Sommerlad腭帆提肌重建术+腭咽肌瓣咽成形术可明显改善大年龄患者术后腭咽闭合功能，在一期手术时应采用这种腭咽联合手术。
목적： 연구2세이상악렬환자술후악인폐합공능적영향인소。방법 대245례2세이상악렬환인술후악인폐합공능화가능영향술후악인폐합공능적인소（악인비치、악렬류형、수술년령、술식）진행회고성연구。결과 악인폐합불전（VPI）조화악인폐합완전（VPC）조술전상대렬극관도、악인비치차이무통계학의의。불동년령조、불동악렬류형술후악인폐합솔미견명현차이。불동적술식술후악인폐합솔차이유통계학의의。결론 대년령악렬환자적치료불의조반2세이하환인단순행악렬정복술적상규치료방안。렬극적대소불시영향대년령악렬환자술후악인폐합공능적주요인소。Sommerlad악범제기중건술+악인기판인성형술가명현개선대년령환자술후악인폐합공능，재일기수술시응채용저충악인연합수술。
Objective To determine the factors affecting post-operative velopharyngeal function of cleft palate patients aged over two years old. Methods The data on 245 patients, including first visit case records and those in the database, were searched and recorded. Post-operative velopharyngeal function and clinical features, such as cleft ratio, adequate ratio, diag-nosis, operative age and method, were analyzed retrospectively. Results Cleft ratio and adequate ratio in the velopharyngeal competence (VPC) group were not statistically different from those in the velopharyngeal incompetence (VPI) group. The difference in VPC rate in different age groups and diagnosis was not significant. The post-operative VPC rates under different methods were significantly different. Conclusion The current therapeutic schedule for patients younger than two years old is inappropriate for patients older than two years old. Cleft ratio is not the main factor affecting postoperative velopharygeal function. Sommerlad-Levator Veli Palatini reconstructional operation combined with sphincter pharyngoplasty can obviously improve the velopharyngeal function of patients aged 2 years old and up. This method should be applied in primary palatoplasty.