上睑下垂225例手术治疗临床观察  

Clinical observation of surgical treatment of ptosis in 225 cases

作　　者：南银娟 欧阳红专[1] 

机构地区：[1]株洲三三一爱尔眼科医院,中国湖南省株洲市412002

出　　处：《国际眼科杂志》2012年第12期2376-2378,共3页International Eye Science

摘　　要：目的:观察治疗上睑下垂的各种术式的疗效及优缺点,为临床选择合理手术方法提供理论依据。方法:回顾性分析我院2008-01/2011-12间225例298眼已施行上睑下垂手术的患者,按照不同的手术方式分为两组:借用额肌力量的手术和提上睑肌复合体的手术。对患者行3～6mo的术后随访观察,进行疗效评价与分析。结果:全部患者分成两组,借用额肌力量的手术患者38例44眼,其中2眼过矫,1眼复发,治愈率93.2%;提上睑肌复合体的手术患者187例254眼,其中4眼过矫,2眼欠矫,治愈率97.6%,明显高于借用额肌力量手术组。2例2眼上睑下垂手术后短期欠矫患者,重新打开切口上调提上睑肌固定位置;1例1眼上睑下垂6mo后复发,再次手术发现缝线脱落给予修复;4例6眼过矫给予松解额肌或提上睑肌调整睑缘位置,均改善了上睑下垂症状和达到了容貌改观。结论:先天性上睑下垂原则上应及早矫治,早手术可防止儿童弱视和心理障碍。后天性上睑下垂病因多样,应根据不同病因进行治疗,待病情稳定3～6mo后根据受术者的病情程度选择不同的上睑下垂矫正术,以提高疗效,并减少并发症。AIM：To observe the advantages and disadvantages of different surgeries for the treatment of ptosis to provide theory and basis for clinical choice of reasonable operation method. METHODS：A retrospective analysis of 225 cases 298 eyes performed ptosis operation in our hospital from January 2008-December 2011. According to the different operation modes patients were divided into two groups： borrow frontalis muscle power operation, as well as the levator palpebrae superioris complex operation. Patients were performed 3-6 months＇ follow-up observation, evaluation and analysis. The effects of two groups were compared.RESULTS： All of the patients divided into two groups, borrowed from the frontal muscle power operation in 38 cases 44 eyes,2 eyes overcorrection, 1 case of recurrence, the cure rate was 93.2%; levator palpebrae superioris complex operation in 187 cases 254 eyes,6 eyes and 2 eyes overcorrection, undercorrection, the cure rate was 97.6%, significantly higher than the amount of muscle strength in use operation group 2 cases 2 eyes with ptosis after operation of short-term undercorrection,reopened incision and upregulated the levator palpebrae superioris muscle fixed position;1 case 1 eye recurred after half year, the re-operation found suture exfoliated then repaired; 4 cases 6 eyes of overcorrection released upper eyelid muscle to adjust the margin position. All surgeries have improved the blepharoptosis symptoms and reached the appearance change.CONCLUSION：Congenital ptosis in principle should be treated early, earlier operation can prevent children from amblyopia and mental disorders. Acquired ptosis due to a variety of causes, which should be treated according to the different causes first, then in stable condition 3-6 months after choose different operation methods. Correction of ptosis based on the severity, select the appropriate operation, improve the curative effect to reduce complications.

关 键 词：上睑下垂 提上睑肌 手术改良 

分 类 号：R779.6[医药卫生—眼科]