Furlow腭成形术对腭裂患者术后腭咽闭合功能及语音效果的影响

Effect of Furlow palatoplasty on velopharyngeal closure and speech outcome in patients with cleft palate

摘要:

目的 探讨Furlow腭成形术对腭裂患者术后腭咽闭合功能及语音效果的影响。方法 选取2018年1月—2021年1月青岛市中医医院收治的78例腭裂患者，按照随机分组法分为研究组和对照组，每组39例。对照组采用两瓣法，研究组采用Furlow腭成形术。比较两组患者手术时间、术中出血量，手术前后腭总长度、软腭长度、咽腔深度、咽腭弓宽度，术后3个月腭咽闭合功能和语音清晰度，以及腭瘘发生情况。结果 研究组手术时间短于对照组（P <0.05），术中出血量少于对照组（P <0.05）；研究组手术前后腭总长度、软腭长度、咽腔深度、咽腭弓宽度的差值大于对照组（P <0.05）；研究组腭咽闭合完全率高于对照组（P <0.05）；研究组语音清晰度优于对照组（P <0.05）；两组患者腭瘘发生率比较，差异无统计学意义（P >0.05）。结论 Furlow腭成形术治疗腭裂患者能够缩短手术时间，减少术中出血量，同时能够恢复腭咽闭合生理解剖形态，改善腭咽闭合功能及语音效果。

Abstract:

Objective To explore the effect of Furlow palatoplasty on velopharyngeal closure and speech outcome in patients with cleft palate after surgery.Methods A total of 78 patients with cleft palate admitted to our hospital from January 2018 to January 2021 were selected and randomly divided into the study group and the control group. The control group was treated with the two-flap palatoplasty, and the study group was treated with Furlow palatoplasty. The operative duration, intraoperative blood loss, the differences of the total palatal length, the soft palate length, the depth of the pharyngeal cavity, and the width of the palatopharyngeal arch before and after the operation, velopharyngeal closure and speech intelligibility 3 months after the operation, and the incidence of palatal fistula were compared between the two groups of patients.Results The operative duration of the study group was shorter than that of the control group (P < 0.05), and the blood loss during operation was lower in the study group than that of the control group (P < 0.05). The differences of total palatal length, soft palate length, the depth of pharyngeal cavity, and the width of the palatopharyngeal arch before and after the operation in the study group were greater than those in the control group (P < 0.05). The rate of complete velopharyngeal closure in the study group was higher than that in the control group (P < 0.05), and the speech intelligibility of the study group was better compared with the control group (P < 0.05). There was no difference in the incidence of palatal fistula between the two groups (P < 0.05).Conclusions Furlow palatoplasty can not only shorten the operative duration and reduce intraoperative blood loss, but also restore the anatomy for complete velopharyngeal closure, thus improving the velopharyngeal closure and speech outcome in patients with cleft palate.