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目的比较腭裂修复术后不同方式处理松弛切口的临床效果。方法回顾性分析2008年1月-2012年12月新疆医科大学第一附属医院口腔颌面外科收治的132例腭裂患者的相关临床病例资料。按照松弛切口的不同处理方式,将纳入病例分为3组:碘仿纱条组(57例)、止血纱布组(39例)及无填塞组(36例)。比较3组患者术后发热、创面出血、穿孔及复裂、创面感染及愈合情况,恶心、进食及口腔卫生情况等。结果 3组患者术后第1天发热发生率差异无统计学意义(P>0.05);而碘仿纱条组患者术后第3、5、7天发热发生率明显高于其他两组(P<0.05);3组术后24h内出血发生率差异无统计学意义(P>0.05),碘仿纱条组24h后出血发生率较其他两组偏高,3组间差异有统计学意义(P<0.05);碘仿纱条组术后恶心、呕吐症状的发生率较其他两组高(P<0.05);碘仿纱条组愈合明显较其他两组慢(P<0.05);3组术后穿孔的发生率差异无统计学意义(P>0.05)。3组患者均未发生术后创面感染及复裂。结论松弛切口无填塞法或填塞可吸收性止血纱布法疗效理想,适合临床推广。
Objective To compare the clinical effects of different ways of treating the incision after cleft palate repair. Methods The clinical data of 132 patients with cleft palate admitted to Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2012 were retrospectively analyzed. The cases were divided into 3 groups according to the different treatment methods of loose incision: iodoform gauze group (57 cases), hemostatic gauze group (39 cases) and no-stuff group (36 cases). The postoperative fever, wound bleeding, perforation and rupture, wound infection and healing, nausea, eating and oral hygiene were compared between the three groups. Results There was no significant difference in the incidence of fever on the first postoperative day among the three groups (P> 0.05). The incidence of fever on the 3rd, 5th and 7th day in the iodoform gauze group was significantly higher than that in the other two groups (P <0.05). There was no significant difference in the incidence of hemorrhage between the three groups within 24 hours after operation (P> 0.05). The incidence of hemorrhage after 24 hours in iodoform gauze group was higher than the other two groups <0.05). The incidence of postoperative nausea and vomiting was significantly higher in the iodoform gauze group than in the other two groups (P <0.05), and the healing rate in the iodoform gauze group was significantly slower than that in the other two groups (P <0.05) There was no significant difference in the incidence of posterior perforation (P> 0.05). None of the three groups experienced postoperative wound infection and rupture. Conclusions Loose incision without packing method or packing absorbable hemostatic gauze method is ideal and is suitable for clinical promotion.