第一章唇腭裂序列治疗概念---唇腭裂咨询网

四、语音治疗

唇腭裂患者语音功能的恢复，除了与术后腭咽闭合是否完全相关之外，还与讲话时舌和下颌不良代偿习惯有关，前者需要通过再次手术解决，后者则需要语音训练纠正。语音治疗的工作一般开始较早。患儿半岁之前，语音病理医师给其父母以语音有关问题的正确指导，共同商议制定矫正患儿语音的训练计划。语音治疗在学龄前的整个时期是很重要的，包括评估、手术治疗、诊断、腭咽闭合功能的检测和语音训练等。

五、中耳疾患及听力减退的治疗

腭裂患儿渗出性中耳炎和听力减退的发病率较高，这主要与咽鼓管功能障碍有关。长期的研究结果表明，腭裂修复术可改善咽鼓管功能。施术年龄越早，中耳炎的发生率就越低。因此，在唇腭裂序列治疗过程中，应经常作中耳功能的检查，一旦发生有渗出性中耳炎和听力减退，应请耳科医师进行专科治疗。

六、牙及牙周病治疗

由于唇腭裂患者口腔解剖结构异常和自洁功能低下，因此唇腭裂患者的牙体及牙周病发生率较一般正常人要高。为保存牙体及牙周组织的正常结构和预防牙体、牙周病的发生，施行适宜的预防和治疗措施是必要的，包括洁牙、窝沟封闭、龋齿及牙周病的一般治疗和恢复口腔正常结构的特殊治疗等。

七、心理治疗

唇腭裂患者多伴有明显的心理障碍，并且在从儿童到成人的每个发育阶段中，其心理发育和心理障碍各有不同特点，这种获得性的心理发育畸形与治疗学和社会学息息相关。Margrit认为，唇腭裂患者儿童及青少年期的心理治疗和患儿早期双亲的心理治疗应在唇腭裂序列治疗中得到足够的重视。目前，在中国还没有专职的唇腭裂心理病理学家，因此，心理治疗的工作应是每个Team成员的责任。

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