0~6岁唇腭裂患儿血液生化指标的变化规律
Changes of blood biochemical indexes in 0-6 years old children with cleft lip and palate

摘要： 目的 探索唇腭裂患儿可耐受唇腭裂手术的相对安全生化值,为尽可能多的唇腭裂患儿适时开展手术治疗,保证患儿可以达到序列治疗的最佳效果。方法 回顾分析了已安全完成唇腭裂修复手术的985例患儿的术前多项生化值,用多种医学统计分析的方法进行交叉对比。结果 患儿的总胆红素、直接胆红素、间接胆红素、白蛋白和肌酐及淋巴细胞和红细胞的95%参考值范围完全包含在标准参考值内,白细胞、血小板、血浆白蛋白和球蛋白的比值（简称白球比）、丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）的95%参考值范围较标准参考值高,血红蛋白、总蛋白、球蛋白和尿素95%参考值范围较标准参考值低;唇腭裂患儿各性别组间血红蛋白、总蛋白、白蛋白、球蛋白和尿素的差异有统计学意义,女性患儿的这些数值要普遍高于男性患儿;单纯唇裂患儿的红细胞、血红蛋白、总蛋白、球蛋白、尿素和肌酐均高于单纯腭裂患儿和唇腭裂患儿;唇腭裂患儿的淋巴细胞、总胆红素、直接胆红素、间接胆红素、ALT和AST均高于单纯腭裂患儿和单纯唇裂患儿。结论 唇腭裂患儿的白细胞、血小板、淋巴细胞、白球比、ALT和AST可能较标准参考值偏高,医生在作术前评估时,可以参考本研究结果,作为开展唇腭裂手术的相对安全指标,以避免错过患儿的最佳手术期,但同时也要更加留意其相关风险性。
Abstract: Objective To find the relative security range of blood biochemical indexes of children with cleft lip and palate to tolerant the operations in order that more timely treatments would be taken and the sequential therapies would get their best results. Methods The preoperative blood biochemical indexes of 985 completed cases of children with cleft lip and palate were analyzed retrospectively in this study, cross correlation using a variety of statistical analysis methods. Results The inner 95% of the reference values of total bilirubin, direct bilirubin, indirect bilirubin, albumin, creatinine, lymphocytes and red blood cells were all contained in their standard reference value ranges. However, the inner 95% of the reference values of white blood cells, platelets, plasma-albumin/globulin(A/G), alanine aminotransferase(ALT), and aspartate transaminase(AST) were higher than their standard reference value ranges, and the inner 95% of the reference values of hemoglobin, total protein, globulin and serum urea were lower than their standard reference value ranges. The values of hemoglobin, total protein, albumin, globulin and serum urea significantly differed between different sex-groups, and these values in female group were significantly higher than those in male group. The values of red blood cell, hemoglobin, total protein, globulin, serum urea and creatinine of children with simple cleft lip were all higher than those of children with simple cleft palate or cleft lip and palate, while the values of lymphocyte, total bilirubin, direct bilirubin, indirect bilirubin, ALT and AST of children with cleft lip and palate were higher than those of children with simple cleft lip or simple cleft palate. Conclusion The values of white blood cells, platelets, lymphocytes, A/G, ALT, and AST of children with cleft lip and palate may be higher than those of adults. During the preoperative assessment, this study can provide references of the relatively safe biochemical indicators for c operations to catch the