Such a group of children are born with deformities, which are more difficult to test than healthy babies in the process of physical and mental development; It is no longer a disease that is difficult to treat; on the contrary, with only a small repair operation in clinical practice, babies can get rid of the trouble of cleft lip and palate and enjoy their laughter as much as other children do In this week’s issue, we invited authoritative experts in pediatric surgery to explain the prevention, treatment and postoperative care of cleft lip and palate for readers and friends, so that mothers to be can prevent cleft lip and palate in a targeted way, and at the same time, more ldquo; baby rabbit Lip rdquo; can find a bright smile as soon as possible
The incidence rate of congenital cleft lip and palate in China is 1.82permil.
Congenital cleft lip and palate, commonly known as ldquo, rdquo, is a common congenital malformation of the maxillofacial region, with an incidence rate of 1.86permil. The incidence rate incidence rate of incidence rate incidence of congenital cleft lip and palate is different.
generally has incidence of 1/500 among Japanese and Indians. The incidence of white is 1/800, of which the incidence rate in Canada and the United States is 1/750-1/1000, and the incidence of black is 1/ 2000.
, the incidence of which is in China is 1.82permil; the incidence of congenital cleft lip and palate is 1/500; the incidence of
according to this incidence rate, the incidence rate of cleft lip and palate children is about 25 thousand in China every year.
is worrying that the incidence of cleft lip and palate is increasing year by year with the influence of environmental pollution and other factors.
Cleft lip and palate can be divided into two types: cleft lip and cleft palate. Cleft lip accounts for more than 70% of congenital cleft lip and palate, and half of cleft lip is accompanied by cleft palate
Cleft lip generally includes the following three types mdash; mdash;
Unilateral cleft lip: first degree cleft lip (only limited to the part of red lip); second degree cleft lip (the part of upper lip is cracked, but the nose bottom is still intact); third degree cleft lip (the whole upper lip is completely cracked to the nose bottom).
Bilateral cleft lip: classify the two sides according to the method of unilateral cleft lip.
Recessive cleft lip: the skin and mucous membrane are not cracked, but the underlying base is not united, resulting in shallow groove depression and separation of lip peak on the affected side
As for cleft palate, it can be divided into unilateral complete cleft palate, bilateral complete cleft palate and incomplete cleft palate
How to prevent and treat cleft lip and palate?
Which pathogenic factors can make the baby “labia rabbit”;
It is believed that cleft lip and palate, as a congenital malformation, mainly occurs in the fourth to tenth week of pregnancy, and some pathogenic factors lead to fetal facial development disorders.
these possible pathogenic factors include the following five categories:
① genetic factors: some children have similar malformations in their immediate or collateral relatives. About 20% of the children with cleft lip and palate can find out their genetic history
(2) infection and injury: in the early stage of pregnancy (about two months), the mother who has been infected with virus, such as influenza, rubella or some kind of injury may be the cause of cleft lip and palate
③ during pregnancy, the mother suffers from chronic diseases such as anemia, diabetes and severe nutritional disorders
④ take some drugs during pregnancy, such as sedatives, antiepileptics and hormones.
During pregnancy, the mother received too much X-ray radiation
In order to protect the baby from cleft lip and palate, we suggest that expectant mothers (especially in the early stage of pregnancy) should try to avoid the pathogenic factors and ensure the healthy development of the fetal face
Cleft lip and palate, when is the most effective repair
After all, with the development of medical technology, the repair technology of cleft lip and palate has been quite mature, and the postoperative effect is very optimistic
At present, the international medical community generally believes that the operation of cleft lip and palate children should be carried out step by step.
generally speaking, the repair of unilateral cleft lip should be carried out three months after birth, and basically follow the international “three 10 rdquo”; The principle is that the body weight is 10 pounds, the age is 10 weeks, and the hemoglobin is 10 grams. The repair of bilateral cleft lip is carried out six months after birth In addition, palatoplasty is performed 10 to 12 months after birth; pharyngoplasty is generally performed at the age of 4 to 5 years (although this operation is not necessary, before this, children need to carry out voice assessment, if there is indeed hypopharyngeal and palatal insufficiency, pharyngoplasty should be performed, if it is only a voice habit problem, it can be completely corrected through voice training without surgery); alveolar cleft Bone grafting was performed around the age of 9 years; the second correction of cleft lip and nose deformity was performed at the age of 13 and 14 years; orthognathic surgery was generally performed at the age of 18 years
It should be noted that children need to have cardiac ultrasonography before the first operation. Among the children with cleft lip and palate, about 4.
07% of them have other congenital diseases, of which the most common is congenital heart disease.
in addition, because cleft palate is easy to cause otitis media, children with cleft palate should also have an ear canal examination before operation.
What to pay attention to in daily feeding after repair
In addition to affecting the beauty of children with cleft lip and palate, it also brings a lot of troubles to the development of the oral cavity Because the upper lip and palate of the mouth are split, it is difficult to form a complete closed negative pressure cavity, so it is difficult for children to complete the sucking action; however, after the change of the distribution and attachment of the muscles in the lip and palate, the muscle and tension are insufficient, which is easy to cause the tongue to retract, and the tongue cannot wrap the pacifier when sucking, and the swallowing function is also hindered.
therefore, a set of scientific methods is needed for feeding children with cleft lip and palate.
We suggest that we should take a sitting position or a 45 degree angle holding position to feed cleft lip and palate baby, and avoid lying flat, so as to prevent the child from coughing; adopt face-to-face feeding mode, which is conducive to observing the child; adopt a prone position, so that the nasal cavity will not cause coughing above the oral cavity; adopt spoon, dropper, collapsible milk bottle or cross opening plastic milk bottle to make feeding more smooth
After cleft lip repair, the child can be discharged 24 to 48 hours after hospitalization; after cleft palate repair, the child can be discharged 48 to 72 hours after hospitalization After repair operation, children with cleft lip should avoid using milk bottle or breast feeding, because sucking of children will cause local tension of the wound to be too large, resulting in incomplete wound healing; children with cleft palate should eat liquid food within two to three weeks after operation, and then change to half liquid food, and can eat ordinary food one month later. In addition, children with cleft palate are strictly forbidden to cry loudly after operation, or put fingers and playthings into the mouth, so as to Anti crack.
(Intern editor: simple)