摘要
目的探讨咽后壁自体脂肪颗粒注射移植在5～7岁腭裂患儿术后腭咽闭合不全治疗中应用的可行性。方法先天性腭裂术后腭咽闭合不全的5～7岁患儿7例,采用腹部抽吸自体脂肪颗粒注射于咽后壁,平均注射量为5.7 mL。分别在术前、术后1周及术后3个月行鼻咽纤维镜检查,对其最大腭咽闭合程度进行等级评价,进行吹水泡试验,对比手术前后的语音评估结果。结果 7例患者术前、术后1周及术后3个月鼻咽纤维镜评估腭咽闭合程度均有改善。术前吹水泡试验时间为(4.71±1.38)s,术后1周及3个月分别为(16.29±3.90)s和(11.14±5.30)s;术前与术后1周(t=9.704,P<0.01)及3个月(t=4.052,P<0.01)比较,术后吹水泡试验时间均有明显延长,差异均具有统计学意义。而术后3个月与术后1周相比时间缩短,其结果差异具有统计学意义(t=4.076,P<0.01)。手术前后语音评估结果与前两种检测方法结果一致。结论自体脂肪颗粒注射移植具有操作可逆、局部创伤小及术后护理简单等优势,能有效增大腭咽闭合最大面积。但其适应证选择需慎重,对于腹壁脂肪层过薄、咽腔过于宽大、腭帆提肌功能未能重建者并不适用。
ObjectiveTo investigate the feasibility of autologous fat transplantion in the treatment of velopharyngeal insufficiency（VPI） during the preschool stage.MethodsSeven preschool children,aged 5 to 7 years-old,with velopharyngeal insufficiency were recruited.Autologous fat harvested by liposuction from abdomen was injected into retropharyns.All cases received nasopharyngeal fiberscope inspection and blowing test before surgery,one week after surgery and 3 months after surgery.The maximum of velopharyngeal closure and result of blowing test were statistically analysed.The result of speech intelligibility test was compared.ResultsCompared to presurgery,all patients＇ level of velopharyngeal closure inspected by nasopharyngeal fiberscope improved in varying degrees one week after surgery,and 3 months after surgery.The time of blowing test one week and 3 months after surgery lasted significantly longer than the time of presurgery（P0.01）.But the time of blowing test reduced 3 months after surgery,compared to one week after surgery,which showed significant difference（P0.01）.The result of speech intelligibility test was smillar with the two resultsabove.ConclusionAutologous fat injection is reversible,less-injuried and easy in post-operative care.It can effectively improve the velopharyngeal insufficiency area.But its indications need to consider carefully.It should not be applied to the patient whose abdominal fat is too thin,pharyngeal is too lenient or the function of levator veli palatini fails to reconstruct.
出处
《广东牙病防治》
2013年第7期348-352,共5页
Journal of Dental Prevention and Treatment
基金
广州市医药卫生科技项目(2009-YB-065)
关键词
腭咽闭合不全
腭裂
自体脂肪颗粒移植
Velopharyngeal insufficiency
Cleft palate
Autologous fat transplantation
