| 摘要: |
| 目的:应用超声观察单纯性腭裂患儿行修补术前使用矫形板对其舌位变化及舌背运动的影响，并探讨其在评估[评估，针对的是超声而不是矫形板]患儿语言功能方面的应用价值。
方法：通过二维超声观察36例行腭裂修补术治疗的单纯性腭裂患儿，为直观呈现观察数据，拟以声像图探头发射点记作O点，入射方向与舌背的交点记作A点，舌背最高点记作B点；以AO间距离表示探头入射方向舌背的高度；AOB角度大小间接说明舌背最高点前后移动的变化。记录修补术前后患儿在发音过程中AO和AOB值，比较其中18例在术前使用矫形板与18例未使用矫形板患儿AO和AOB值差异情况，并与正常儿童AO和AOB值进行比较，同时对两组患儿手术前后发音清晰度进行评估。
结果：腭裂患儿术前AO值均显著低于正常对照组（使用矫形板组3.61±0.15 vs 4.18±0.16, P<0.05；未使用矫形板组3.53±0.34 vs 4.18±0.16, P<0.05；），AOB值均显著高于正常对照组（使用矫形板组34±5vs20±1, P<0.05；未使用矫形板组32±4vs20±1, P<0.05），说明超声测量值能有效反映腭裂患儿舌背下移舌体收缩的现象；行腭裂修补术患儿使用矫形板与否，术后AO值均较术前升高，AOB值均较术前降低，且差异具有统计学意义（均P<0.05），说明超声测量值能有效反映腭裂患儿修补术前后舌背下移舌体收缩的变化；术前使用矫形板组AO和AOB值数据相较于未使用矫形板组标准差小，数据离散度低，说明矫形板的出现可有效防止在发音时舌头的不规则运动；同时术前使用矫形板组获得良好发音的比例显著高于从来没有使用过矫形板组，说明超声评估矫形板使用对语言功能的恢复同语音测试有较高的一致性。
结论：超声可作为评估单纯性腭裂患儿舌头不规则运动及术后发音功能的一种有效手段。 |
| 关键词: 超声 腭裂 矫形板 舌运动 发音 |
| DOI： |
| 投稿时间：2017-12-10修订日期：2018-02-12 |
| 基金项目: |
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| The clinical value of ultrasonographic assessment of tongue movement in children with cleft palate |
| zhangyang,yushanshan,chenke,huohuanhuan,huanglili,zhouqi |
| () |
| Abstract: |
| Objective To investigate the value of ultrasound in assessing the impact of preoperative use of an orthopedic plate(OP) in improving pronunciation of children with cleft palate.
Method Ultrasound was performed in 36 surgery treated children with cleft palate. To facilitate the visual presentation of data we observed, we formulated a recording method in which probe was set as point O, the intersection point of incident direction in tongue back?as point A and the peak of?tongue back?as point B. Values of AO and AOB were used to state the height of tongue back and the change of peak of tongue back. Among the 36 children patients who received surgery, 18 used orthopedic plate, while the other 18 not used. AO value and AOB value of both of them were recorded and compared with healthy children. Simultaneously, speech outcome of the two groups of patients were evaluated pre and post operation.
Result Before surgery, AO value of children patients was significantly lower than healthy children, and AOB value was obviously higher than the healthy children, indicating that ultrasonographic assessment showed tendency of tongue back down and tongue body contraction of children with cleft palate . After the operation, AO value was upregulated, AOB value was decreased compared with pre-operation values, and the difference was statistically significant (all P<0.05), evidenced that ultrasonographic assessment showed the surgery achieved its goal of improving?tongue back elevation and the tongue body protraction; Preoperative use of OP group’s AO and AOB value data compared with unused OP standard deviation was small, discrete degree was low, the data showed that the orthopedic plate can effectively prevent the irregular movement of the tongue;At the same time preoperative use of OP group had a significantly higher percentage of good pronunciation than never use OP group, It was indicated that the ultrasonic evaluation of OP was consistent with the speech test.
Conclusion Ultrasound can be used as an effective method to evaluate the early continuous use of OP to inhibit the irregular movement of the tongue and improve the postoperative pronunciation. |
| Key words: ultrasound cleft palate orthopedic plate(OP) movements of the tongue articulation |
