眶上动脉蒂额部皮瓣修复上睑缺损  

Upper eyelid reconstruction with forehead skin flap with base at the supraorbital artery region

作　　者：何林[1] 管延续[2] 王瑞林[2] 黄立[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院整形外科,武汉430030 [2]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《中华眼科杂志》2012年第3期253-257,共5页Chinese Journal of Ophthalmology

摘　　要：目的探讨应用眶上动脉蒂额部皮瓣结合游离黏膜移植修复炎症、外伤后的上睑大面积缺损的方法和效果。方法回顾性系列病例研究。收集华中科技大学附属同济医院2003年9月至2008年7月共9例上睑缺损患者的临床资料。患者均以缺损对侧眶上动脉为蒂的额部皮瓣经皮下隧道转移至缺损上睑，并做额肌瓣辅助再造上睑的睁眼功能，结合游离黏膜移植完成上睑缺损的修复。术后随访1—5年，通过临床观察和调查问卷的模式，从功能、外形以及患者的满意度3个方面进行评价。结果9例患者眶上动脉供血的额部皮瓣全部成活，皮瓣血供稳定，质地、色泽都与眼睑极为相似，具有感觉神经支配。术后出现1例上睑闭合不全，1例皮瓣肥厚，2例蒂部臃肿，均在术后半年手术修复。随访1-5年，均取得了满意的治疗效果。结论眶上动脉供血的额部皮瓣是修复上睑组织缺损的理想皮瓣供区。Objective In order to find an ideal method to reconstruct the upper eyelid defect resulted from trauma or inflammation, we explored the possibility of using forehead skin flap with the base at the supraorbital artery region and combined with free mucous membrane transplanting. Methods This article was a retrospective case series analysis. Nine cases of upper eyelid defect have been collected from September 2003 to July 2008 in Tongji Hospital, Huazhong University of Science and Technology. We designed a forehead skin flap with the base at the opposite side supraorbital artery region transferring from the subcutaneous tunnel and combined with free mucous membrane transplanting to reconstruct the defected eyelid. We also made a forehead muscle in auxiliary to achieve upper eyelid elevating function. We followed up 1 to 5 years by Clinical observation and questionnaire survey from fuction, appearance and patient satisfaction. Results All of these nine forehead skin flaps were survived. These flaps had stable blood supply, similar texture and color as well as fine feeling. The postoperative complications included 1 case of upper eyelid dysraphism, 1 case of skin hypertrophy, 2 cases of pedicle overstaffed, all these complications have been repaired in half a year after the operation. We followed up 1 to 5 years, every patient had got a good repair effect. Conclusion The forehead skin flap with the base at the supraorbital artery region is an ideal flap supply for repairing upper eyelid defect.

关 键 词：外科皮瓣 眼睑 修复外科手术 

分 类 号：R779.6[医药卫生—眼科] R622[医药卫生—临床医学]