Læknablaðið - 15.10.1996, Blaðsíða 23

LÆKNABLAÐIÐ 1996; 82
703
Rannsóknir á skarðasjúklingum
Yfirlitsgrein
Fyrsta grein
Árni Björnsson, Gunnhildur Jóhannsdóttir
Björnsson Á, Jóhannsdóttir G
Overview and follow up study of cleft patients
Læknablaðið 1996; 82: 703-13
On the average 8.2 children with different types of
facial clefts are born in Iceland every year, which
means approximately 1.87 per 1000 births. Until just
before the middle of this century most of those
children were treated by general surgeons or not at
all, and a few were sent abroad.
Around 1950 an orthopedic surgeon with some
training in plastic surgery joined the staff at Land-
spítalinn (University Hospital in Reykjavík). Soon
practically all children with clefts were referred to
him and as the only obstetrical and gynaecological
and only pediatric unit in the country were stationed
there, Landspítalinn became a center for cleft treat-
ment and has remained so.
The senior author (ÁB) took over the treatment of
clefts between 1955 and 1960 and treated about 90%
of the children until 1993. The aim of the paper is to
give an overview over treatment of clefts in Iceland
over this period.
Landspítalinn was founded in 1930. All hospital re-
cords for patients with clefts were looked into, clas-
sified and devided into three groups after the ICD
system. A simple record was made for each patient
with general informations and special records for
those born between 1955-1984, 312 in all, for special
scrutiny. In those records all known informations
are to be found; kinship, mothers use of drugs in
pregnancy, operations, time of operations and sur-
geon’s name were recorded.
Frá Barnaspítala Hringsins og lýta- og handlækningadeild
Landspítalans, 101 Reykjavlk. Fyrirspurnir, bréfaskipti: Árni
Björnsson, Bókasafni Landspítalans, Eirbergi, 101 Reykja-
vík.
The operations were devided into main groups and
sub groups, auxiliary treatment was recorded as
were all complications and diseases related to the
clefts. It was also recorded if the cleft was a part of a
syndrome or associated with other major congenital
deformities.
The informations so gained will be a basis for further
studies related to evaluation of the treatment and
further genetic studies.
Ágrip
I greininni er sagt frá upphafi skarðameð-
ferðar á Islandi og drepið á skipulagningu
skarðameðferðar í öðrum menningarlöndum.
Þá er sagt frá skörðum á íslandi og meðferð
þeirra, ritum um skörð og skarðameðferð,
faraldsfræði skarða og ættartengslum skarða-
sjúklinga.
Skoðaðar hafa verið sjúkraskrár allra
skarðasjúklinga á Landspítalanum frá upphafi,
alls 433, og þær flokkaðar í þrjá flokka eftir
ICD kerfinu. Gerð var sjúkraskrá með al-
mennum upplýsingum fyrir hvern sjúkling en
sérstakar sjúkraskrár til ítarlegrar skoðunar
fyrir þá sem fæddir voru á árabilinu 1955-1984,
alls 312. Tveir sjúklingar féllu úr, annar kom
aldrei til meðferðar, hinn dó skömmu eftir
fæðingu, svo heildartalan varð 310. Auk al-
mennra upplýsinga og lýsingar á vansköpun-
inni voru skráð ættartengsl og allar aðgerðir
með tímasetningu og nafni skurðlæknis.
Aðgerðum var skipt í aðal- og undirflokka,
skráð var stoðmeðferð, fylgikvillar aðgerðar
og sjúkdómar tengdir skörðum, þá var skráð ef
skarðið var hluti af heilkenni, en heilkenni
telst hafi einstaklingur fleiri en einn meðfædd-
an galla. Loks er gerð grein fyrir hugmyndum