B型超声波在单侧唇裂术后评估中的应用探讨(1)
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[摘要]目的：探讨B超在单侧唇裂术后疗效评估中的应用价值。方法：以B超对36例单侧唇裂术后患者的上唇进行探测，在B超下测量口轮匝肌瘢痕的宽度、厚度。测量6项唇部术后外观评价指标，分析口轮匝肌修复重建效果，瘢痕愈合情况与外观评价的关系。结果：6项外观评价指标与瘢痕宽度相关性有统计学意义；口轮匝肌重建修复效果好，瘢痕宽度小的，外观评价优良；口轮匝肌重建修复效果差，瘢痕宽度宽的，外观评价较差。结论：B超观察唇裂术后口轮匝肌修复重建效果和检测瘢痕宽度可作为一项评价单侧唇裂术后疗效评估的客观量化指标。
[关键词]单侧唇裂；B超；口轮匝肌；术后评估
[中图分类号]R782 [文献标识码]A [文章编号]1008-6455(2012)01-0049-03
Application of the high frequency ultrasound in postoperative evaluation of unilateral harelip
CHEN Bao-feng1,WEI Qiang1,MO Chun-ling2,LIAO Xin-hong2
(1.Department of Plastic Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China;2.Deparment of UItrasonic Diagnosis,The First Affiliated Hospital of Guangxi Medical University)
Abstract: Objective The purpose of this study was to use the high frequency ultrasound to evaluate the operation effect after primary unilateral harelip repair. Methods Using the high frequency ultrasound to observe the upper lip orbicularis oris of 36 adult postoperative patients of unilateral harelip,measure the cicatrix width and thickness of orbicularis oris,then analyze the relation with 6 indexs of upper lip deformity.Analyze the the relation between plerosis effect of orbicularis oris and hand evaluation of postoperative patients. Results 6 indexs of upper lip deformity and cicatrix width are statistically significant correlation;It is associated with better orbicularis oris plerosis,smaller cicatrix width and good hand evaluation of postoperative patients. Conclusion Ultrasound technology not only can be used to observe the plerosis effect of orbicularis oris,but also used to evaluate the operation effect.
Key words:unilateral harelip;B ultrasound;orbicularis oris;postoperative assessment
口轮匝肌的修复重建是唇裂整复术中极其重要的一环。但对其修复重建后的研究较少，对口轮匝肌重建修复效果和口轮匝肌瘢痕愈合情况的研究尚为空白。本文以B超对36例单侧唇裂术后患者的口轮匝肌进行观测，分析口轮匝肌的变化与术后唇部外观的关系，尝试将口轮匝肌重建修复效果及瘢痕情况作为唇裂术后远期疗效的评估的一个客观指标，现报道如下。
1 材料和方法
1.1研究对象：收集本科2010年8月～2011年5月单侧唇裂术后患者共36例(男29例，女7例)，年龄19～25岁，均为单侧唇裂，术后均未行二期手术。
1.2仪器：美国GE公司生产的型号GE-LOGIQ9的彩色超声探测仪，探头频率为10～14MHz，图像处理软件为TruAccess原始数据处理技术。
1.3研究方法
1.3.1测量方法：受检者取仰卧位，口唇自然微闭，于上唇及超声探头上涂布超声耦合剂，将探头横置于上唇检测，以获得清晰的上唇口轮匝肌超声图像且人中凹及左、右侧人中嵴的弧度未见明显变形为标准切面，在B超声像图下测量口轮匝肌瘢痕的宽度、厚度。测量健患侧鼻翼唇峰距之比、健患侧鼻翼口角距之比、健患侧唇峰口角距之比、健患侧人中嵴高度之比、健患侧鼻小柱基点-口角距之比以及健患侧鼻小柱基点-唇峰距之比 ......
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