de Ladeira Pedro Ribeiro Soares, Alonso Nivaldo
School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
Plast Surg Int. 2012;2012:562892. doi: 10.1155/2012/562892. Epub 2012 Nov 1.
Objectives. To find clinical decisions on cleft treatment based on randomized controlled trials (RCTs). Method. Searches were made in PubMed, Embase, and Cochrane Library on cleft lip and/or palate. From the 170 articles found in the searches, 28 were considered adequate to guide clinical practice. Results. A scarce number of RCTs were found approaching cleft treatment. The experimental clinical approaches analyzed in the 28 articles were infant orthopedics, rectal acetaminophen, palatal block with bupivacaine, infraorbital nerve block with bupivacaine, osteogenesis distraction, intravenous dexamethasone sodium phosphate, and alveoloplasty with bone morphogenetic protein-2 (BMP-2). Conclusions. Few randomized controlled trials were found approaching cleft treatment, and fewer related to surgical repair of this deformity. So there is a need for more multicenter collaborations, mainly on surgical area, to reduce the variety of treatment modalities and to ensure that the cleft patient receives an evidence-based clinical practice.
目的。基于随机对照试验（RCT）寻找唇腭裂治疗的临床决策。方法。在PubMed、Embase和Cochrane图书馆中检索唇裂和/或腭裂相关文献。在检索到的170篇文章中，28篇被认为足以指导临床实践。结果。发现关于唇腭裂治疗的随机对照试验数量稀少。28篇文章中分析的实验性临床方法包括婴儿矫形术、直肠对乙酰氨基酚、布比卡因腭部阻滞、布比卡因眶下神经阻滞、骨生成牵张、静脉注射地塞米松磷酸钠以及使用骨形态发生蛋白-2（BMP-2）进行牙槽成形术。结论。发现关于唇腭裂治疗的随机对照试验很少，与这种畸形手术修复相关的更少。因此，需要更多的多中心合作，主要在手术领域，以减少治疗方式的多样性，并确保唇腭裂患者接受基于证据的临床实践。
