大龄腭裂患者术后腭咽闭合功能的影响因素分析
Factors affecting the postoperative velopharyngeal function among aged patients with cleft palate
作者：刘楚娴,李精韬,郑谦,郭春丽,尹恒
Author：Liu Chuxian,Li Jingtao,Zheng Qian,Guo Chunli,Yin Heng
收稿日期：2018-11-13 年卷（期）页码：2019,37(6):626-626-630
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：腭裂,腭咽闭合不全,大龄患者,logistic回归,
Key words：cleft palate,velopharyngeal insufficiency,aged patient,logistic regression,
基金项目：
中文摘要
目的 探究大龄腭裂患者一期腭裂整复术后腭咽闭合功能的影响因素。方法 本研究回顾了2009—2014年间在四川大学华西口腔医院唇腭裂外科以Furlow术式行手术治疗的大龄腭裂患者（手术年龄≥5岁）,收集其软腭长度、咽腔深度、腭裂宽度、上颌宽度、腭裂指数和腭咽比6项指标的术中测量数据以及术后至少1年的语音复诊结果,进行logistic回归分析。结果 共纳入患者131人,其中男性70人,女性61人。logistic回归分析发现患者咽腔深度同术后腭咽功能强相关,咽腔深度越大,术后腭咽闭合不全风险升高。咽腔深度大于16 mm的患者术后腭咽闭合功能显著性降低,其他测量指标同术后腭咽功能无明显关联性。结论 大龄腭裂患者咽腔深度是其术后腭咽功能的敏感预测指标。对于咽腔深度大于16 mm的患者,可考虑一期手术时同步实施腭咽联合手术,以创造更好的腭咽闭合条件。
英文摘要
ObjectiveTo explore the prognostic factors affecting the primary surgical management of aged patients with cleft palate.MethodsThis study reviewed aged patients with cleft palate who received Furlow palatoplasty (surgical age≥5 years) at the cleft center at West China Hospital of Stomatology from 2009 to 2014. The study retrieved intraoperative measurements, including velar length, pharyngeal depth, cleft width, maxillary width, cleft palate index, and palatopharyngeal ratio. Speech evaluation results at follow-up at least a year after surgery were also obtained. Logistic regression and retrospective analyses were performed to identify correlative prognostic factors.ResultsOne hundred and thirty-one patients were included (70 males and 61 females). Dichotomy logistic regression analysis revealed that pharyngeal depth was the only measurement considerably associated with postoperative velopharyngeal function. Pharyngeal depth deeper than 16 mm indicated high risk of postoperative velopharyngeal insufficiency.ConclusionPharyngeal depth is a significant prognostic factor for the primary surgical management of aged patients with cleft palate. Pharyngoplasty might be considered when planning the primary management of aged patients.
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