唇腭裂术前正畸治疗对上唇软组织影响的临床研究

为探讨先天性单侧完全性唇裂患儿术前给予上颌腭托矫治器（PNAM）＋透明防过敏胶布减张固定的正畸治疗效果．选取40例排除唇裂手术禁忌症的先天性单侧完全性唇裂患儿，20例出生后4周给予佩戴PNAM＋胶布减张固定至唇裂修复术前，20例给予观察至唇裂修复术前．分别测量两组患儿上唇组织变化，结果采用配对t检验进行统计学分析．结果显示：实验组患儿术前正畸治疗后患侧上唇组织长度平均增加6．90mm、患侧侧上唇组织高度平均增加3．69mm，健侧上唇组织高度平均增加4．10mm，实验组裂隙宽度减小2．41mm，而对照组裂隙增宽3．88mm．统计学分析差异显著．表明PNAM＋胶布减张固定的术前正畸方法。有助于先天性单侧唇腭裂患几上唇软组织的生长改建。从而降低手术难度，减小术后瘢痕形成．

Clinical research of the effect of presurgical orthodontic treatment applied in the unilateral cleft lip and palate-babies-on-upper-lip-soft-tissue

The aim of the study is to evaluate the treatment outcome in congenital unilateral completely cleft lip and palate. These infants wore presurgical nasoalveolar molding（PNAM） and fixed it with tapes which is breath- able and can reduce tension. Forty cases of unilateral completely cleft lip and palate were selected without op- eration contraindication. Twenty cases were treated with PNAM and tapes after four-week older till the lip re- pair surgery, and the other twenty cases were observed until this surgery. The experiment measured the length and height of the lips of both healthy side and diseased side, and their width of cleft. Then it analyzed the data with SPSS19.0. Results showed that the experimental group＇s diseased side＇s upper lip tissue＇s length in- creased by 6.90 mm averagely ; the diseased side＇s upper lip tissue＇s height increased by 3.69 mm averagely; while the normal side＇s upper lip tissue＇s height increased by 4.10 mm averagely. And the width of the cleft of experimental group reduced by 2.41mm, comparing with the 3.88mm of the control group which was statistically significant. Conclusion was that Presurgical orthodontic treatment with PNAM and tape helped deform lips to develop in the approximately normal direction. It changed the maxillary bone＇s growth direction, at the same time it induced lips grow to the same direction. Because of the adequate length, the tension would reduce during the lip repair surgery, and the scar would become less obvious.