Werker C L, de Wilde H, Mink van der Molen A B, Breugem C C
Department of Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
Department of Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
J Plast Reconstr Aesthet Surg. 2017 Dec;70(12):1732-1737. doi: 10.1016/j.bjps.2017.04.011. Epub 2017 Apr 23.
The treatment approach for internationally adopted children with cleft lip and/or palate differs from locally born children with cleft lip and/or palate. They are older at initial presentation, may have had treatment abroad of different quality, and are establishing new and still fragile relationships with their adoptive parents. The aim of this study was to describe the characteristics and initial care and treatment of this group.
A retrospective cohort study was performed including all internationally adopted children with cleft lip and/or palate presenting to the cleft team outpatient clinic in the Wilhelmina Children's Hospital between January 1994 and December 2014. Medical records of all patients were reviewed; information concerning demographic characteristics, characteristics at initial presentation, and treatment were obtained.
A total number of 132 adopted patients were included: 15% had cleft lip, 7% had cleft palate, and 78% had cleft lip and palate. The average age at the time of adoption was 26.5 months. In most cases, China was the country of origin. Seventy-eight percent had surgery in their country of origin, primarily lip repair. Fistulae in need of revision surgery were found in 8% of the patients. Pharyngoplasty was needed in 48% of the patients. No significant differences were found for mean age at adoption, gender, cleft type, and one- or two-stage palatal closure.
Internationally adopted children with cleft lip and/or palate are a very diverse group of patients with challenging treatment. These children undergo surgery late and frequently need additional surgery.
国际收养的唇腭裂儿童的治疗方法与本地出生的唇腭裂儿童不同。他们初次就诊时年龄较大，可能在国外接受过质量参差不齐的治疗，并且正在与养父母建立新的、仍然脆弱的关系。本研究的目的是描述这一群体的特征以及初始护理和治疗情况。
进行了一项回顾性队列研究，纳入了1994年1月至2014年12月期间在威廉明娜儿童医院腭裂团队门诊就诊的所有国际收养的唇腭裂儿童。查阅了所有患者的病历；获取了有关人口统计学特征、初次就诊时的特征以及治疗的信息。
共纳入132名收养患者：15%为唇裂，7%为腭裂，78%为唇腭裂。收养时的平均年龄为26.5个月。在大多数情况下，中国是原籍国。78%的患者在原籍国接受了手术，主要是唇修复术。8%的患者发现有需要修复手术的瘘管。48%的患者需要进行咽成形术。在收养时的平均年龄、性别、腭裂类型以及一期或二期腭裂关闭方面未发现显著差异。
国际收养的唇腭裂儿童是一组非常多样化的患者，治疗具有挑战性。这些儿童手术时间较晚，并且经常需要额外的手术。
