50例唇腭裂患儿手术前、后血液生化指标及腭裂隙内骨再生评价

doi:10.19438/j.cjoms.2020.01.011

摘要/Abstract

摘要： 目的: 探讨唇腭裂患儿手术前、后血液生化指标的变化,以及手术对腭裂隙内骨再生的影响。方法: 选取2014年4月—2016年4月进行手术的唇腭裂患儿50例,比较手术前、后白细胞、血小板、血浆白蛋白和球蛋白比值(简称白球比)、丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)等,以及牙弓前段、中段、后段宽度,腭部面积、腭部裂隙宽度,牙槽突裂隙宽度,牙槽突裂隙矢状向距离、水平向距离,前颌突倾斜度、裂隙面积的差异。采用SPSS 19.0软件包对数据进行统计学分析。结果: 手术后患儿白细胞、血小板、血浆白蛋白和白球比、ALT和AST等指标显著低于手术前(P<0.05);手术后再生骨桥阳性率为80.0%,再生骨桥平均长度为(12.3±3.6)mm,平均宽度为(12.3±2.3)mm,牙弓前段平均宽度为(31.6±2.9)mm,牙弓中段平均宽度为(41.2±6.2)mm,牙弓后段平均宽度为(51.6±6.9)mm,均显著小于手术前(P<0.05);手术后腭部面积、腭部裂隙宽度、牙槽突裂隙宽度、牙槽突裂隙矢状向距离、水平向距离、前颌突倾斜度、裂隙面积与手术前存在显著差异(P<0.05)。结论: 唇腭裂患儿手术后血液生化指标发生明显变化;腭裂隙内骨再生骨桥形成,有利于唇腭裂患儿牙弓及上颌骨发育。

关键词: 唇腭裂, 血液生化指标, 腭裂隙内骨再生, 牙弓宽度

Abstract: PURPOSE: To study the changes of blood biochemical indexes before and after operation in 50 children with cleft lip and palate and the effect of operation on bone regeneration in cleft palate. METHODS: From April 2014 to April 2016, 50 patients with cleft lip and palate were included. All children were treated surgically. The ratio of white blood cells, platelets, plasma albumin and globulin (hereinafter referred to as white blood cell ratio), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were compared, and the difference of the width of the anterior segment, middle segment, posterior segment width, the area of palate, the width of the cleft lip, the width of the alveolar process, the sagittal distance, the horizontal distance, the inclination of the maxillary protrusion and the fissure area were compared with SPSS 19.0 software package. RESULTS: The white blood cells, platelets, plasma albumin and globulin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly lower than those before operation (P<0.05). The positive rate of regenerated bone bridge after operation was 80.0%. The average length and width of regenerated bone bridge were (12.3±3.6) mm and (12.3±2.3) mm, respectively. The average width of anterior arch, middle arch and posterior arch were (31.6±2.9) mm, (41.2±6.2) mm and (51.6±6.9) mm, respectively, which were significantly smaller than those before surgery (P<0.05). There were significant differences in area of palate, width of cleft palate, sagittal distance of alveolar fissure, horizontal distance, inclination of anterior maxillary process, area of fissure before and after operation (P<0.05). CONCLUSIONS: The changes of blood biochemical indexes are obvious in children with cleft lip and palate after operation. The formation of regenerative bone bridge in upper palate fissure is beneficial to the development of dental arch and maxilla in children with cleft lip and palate.

Key words: Cleft lip and palate, Blood biochemical index, Bone regeneration in palate fissure, Arch width

中图分类号:

R782.2

姚志涛, 安玮, 买买提吐逊·吐尔地. 50例唇腭裂患儿手术前、后血液生化指标及腭裂隙内骨再生评价[J]. 中国口腔颌面外科杂志, 2020, 18(1): 56-59.

YAO Zhi-tao, AN Wei, MAIMAITITUXUN·Tuerdi. Blood biochemical indexes and bone regeneration in 50 children with cleft lip and palate before and after operation[J]. China J Oral Maxillofac Surg, 2020, 18(1): 56-59.

参考文献

[1] Sundell AL, Ullbro C, Marcusson A, et al.Comparing caries risk profiles between 5- and 10- year-old children with cleft lip and/or palate and non-cleft controls[J]. BMC Oral Health, 2015, 15: 85.
[2] 蒲泓伶, 陈丽先, 龚彩霞, 等. 0~6岁唇腭裂患儿血液生化指标的变化规律[J]. 国际口腔医学杂志, 2017, 44(4): 385-389.
[3] Russell K, Long RE Jr, Daskalogiannakis J, et al.A multicenter study using the SWAG scale to compare secondary alveolar bone graft outcomes for patients with cleft lip and palate[J]. Cleft Palate Craniofac J, 2016, 53(2): 180-186.
[4] 石冰, 傅豫川, 尹宁北, 等. 唇腭裂序列治疗与关键技术的应用[J]. 华西口腔医学杂志, 2017, 35(1): 8-17.
[5] Xiao WL, Zhang DZ, Chen XJ, et al.Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography[J]. Int J Oral Maxillofac Surg, 2016, 45(6): 683-687.
[6] 范存晖. 生长发育期唇腭裂患者的序列正畸治疗[J]. 中国实用口腔科杂志, 2015, 8(3): 133-137.
[7] Zhang DZ, Xiao WL, Zhou R, et al.Evaluation of bone height and bone mineral density using cone beam computed tomography after secondary bone graft in alveolar cleft[J]. J Craniofac Surg, 2015, 26(5): 1463-1466.
[8] Li L, Liao L, Zhong Y, et al.Variation trends of the postoperative outcomes for unilateral cleft lip patients by modified Mohler and Tennison-Randall cheiloplasties[J]. J Craniomaxillofac Surg, 2016, 44(11): 1786-1795.
[9] Li L, Liao L, Zhong Y, et al.A modified Mohler technique for patients with unilateral cleft lip based on geometric principles--a primary report[J]. J Craniomaxillofac Surg, 2015, 43(5):663-670.
[10] Jiang C, McPherson B, Ng ML. Voice onset time of alveolar stop /t/ and realization of unaspirated affricates associated with Mandarin-speaking children with repaired cleft palate[J]. Int J Pediatr Otorhinolaryngol, 2016, 86: 150-155.
[11] Jiang C, Whitehill TL, McPherson B, et al. Spectral moment analysis of affricates produced by Mandarin-speaking preadolescents with repaired cleft palate[J]. Int J Pediatr Otorhinolaryngol, 2016, 84: 137-142.
[12] Jiang C, Whitehill TL, McPherson B, et al. Consonant accuracy in Mandarin-speaking children with repaired cleft palate[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(12): 2270-2276.
[13] Jiang C, Whitehill TL, McPherson B, et al. Spectral features and perceptual judgment of place of affricate in Putonghuaspeaking pre-adolescents with normal and cleft palate[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(2): 179-185.
[14] 李盛, 江宏兵, 万林忠, 等. 联合应用Sommerlad与Furlow术式治疗腭咽闭合不全[J]. 口腔医学, 2016, 36(5): 425-428.
[15] 钟渝翔, 李万山, 李远贵, 等. 鼻牙槽嵴塑形矫治器在单侧完全性唇腭裂腭部畸形矫治中的效果评价[J]. 华西口腔医学杂志, 2014, 32(2): 145-149.
[16] 王留宏, 张冬林, 娄新田, 等. 口腔正畸矫治牙槽突植骨术后唇腭裂临床疗效观察[J]. 河北医学, 2015, 21(1): 144-146.
[17] 常乐, 王英男, 刘红彦. 唇腭裂患者正畸扩弓与植骨时机的探讨[J]. 华西口腔医学杂志, 2016, 34(2): 205-209.
[18] Façanha AJ, Lara TS, Garib DG, et al.Transverse effect of Haas and Hyrax appliances on the upper dental arch in patients with unilateral complete cleft lip and palate: a comparative study [J]. Dental Press J Orthod, 2014, 19(2): 39-45.