儿童额肌腱膜悬吊术治疗先天性上睑下垂临床评估  

The clinical analysis of frontal muscle aponeurosis suspension in congenital ptosis

作　　者：吴倩[1] 樊云葳[1] 曹文红[1] 胡守龙[1] 于刚[1] 

机构地区：[1]首都医科大学附属北京儿童医院眼科儿科学国家重点学科,100045

出　　处：《中国斜视与小儿眼科杂志》2013年第2期1-6,I0004,共7页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的评估先天性上睑下垂患儿行额肌悬吊术后功能及美容疗效。方法对500例(574眼)先天性上睑下垂患儿行额肌悬吊术的疗效进行回顾性分析,手术年龄6月～12岁,平均5.4岁。对眼睑高度、睑缘弧度、双重睑、双眼外观、额肌力及并发症进行观察及统计学处理。结果①功能满意评估:睑裂高度术前平均3.2mm(1.9～6mm);术后1、6、12月分别为8.4(5～11mm)、8.1(4～11mm)、7.6(4～10mm),满意度分别为100%、97%、94%,术前与术后各月比较均有统计学差异;②美容满意评估:将术后眼睑轮廓平滑、双侧眼睑高度对称、双重睑外观的美容效果均评分做满意度评估,1个月满意度分别为97.9%、84.2%、91%,12月分别为96.6%、86.8%、87.6%③术后并发症:术后1月内有12眼分别发生暴露性角膜炎(2眼),内翻倒睫(5眼),结膜脱垂(3眼),过矫(2眼),经治疗后均痊愈;12月后有眼睑闭合不良1眼,重睑不满意14眼,皮肤瘢痕1眼,复发5眼。对于复发5眼在适当时机进行手术。结论儿童采用额肌悬吊术矫正先天性上睑下垂近期功能评估满意,并能明显改善外观,术式安全可靠,手术并发症较少;但如何较好保持远期疗效,还需进一步探索。Objective To analysis the functional and Cosmetic outcome after frontalis muscle suspension surgery of congenital ptosis. Methods 500 cases （574 eye） of congenital blepharoptosis were treated by frontalis muscle sus- pension surgery , aging from 6 months-72 months （average 5.4 years）. Height of eyelid, palpebral margin radians, dou- ble eyelids, appearance, frontal muscle strength and complications were observed and underwent statistical analysis. Results （1） functional satisfaction assessment： average of height of eyelid before surgery was 3.2mm （1.9-6mm）; while 1, and 6, and 12 months after operation was 8.4mm （5-11mm）, 8.1mm （4-11ram）, and 7.6mm （4-10mm）respeetively; satisfaction rate is 100%, and 97%, and 94%, which has statistics differences; （2） cosmetology satisfaction assessment： to score the satisfaction level of eyelid profile smooth, symmetric of binoculus eyelid height, and double eyelid appearance, the satisfaction rate was 97.9%, and 84.2%, and 91% respectively 1 month after surgery, and was 96.6%, and 86.8%, and 87.6% 12 months after surgery. （3） complications： complications were found in 12 eyes within 1 month after operation （2 eye of exposure keratitis, 5 eyes of trichiasis, 3 eyes of conjunctival prolapse, 2 eyes of overcorreetion）, all the pa- tients were recovered under active treatment; complications were found in 21 eyes after 12 months of surgery, 1 eye of in- complete of eyelid closure, 14 eyes of dissatisfaction of double eyelid on lateral canthus, 1 eye of scar, 5 eyes of recur- renee which were underwent operation again. Conclusions ptosis has a good functional outcome and cosmetic effect, the operation was safe and reliable with few postoperative Frontalis muscle suspension surgery for correction of congenital complications. Functional satisfaction dropped slightly after 12 months of surgery, the rate of satisfaction was down in some patients, mainly because of eyelid height declined gradually, and the appearance of double eyelid is not id

关 键 词：先天性上睑下垂 额肌悬吊 功能疗效 美容疗效 

分 类 号：R779.6[医药卫生—眼科]