先天性上睑下垂发病机制与手术设计的研究  

Study on the mechanism and surgical design of congenital ptosis

作　　者：康宛夏[1] 郑大文[1] 任晓霞[1] 冀春萱[2] 

机构地区：[1]山西省眼科医院,030002 [2]山西医科大学

出　　处：《眼外伤职业眼病杂志》2002年第1期23-25,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的 探讨先天性上睑下垂的发病机制，为手术方法的设计提供依据。方法 对７３例（１０３眼）先天性上睑下垂进行了上睑提肌肌力、肌电图、肌弹性的测量及解剖学、组织学方面的观察。结果 肌电图显示该肌收缩强度正常平均值为５００μＶ／Ｄ，部分肌力较差的患者（１８％）肌收缩强度达２６０～３５０μＶ／Ｄ接近正常平均值，少数肌力在３～５ｍｍ的患者（９．９９％）肌收缩强度达到正常平均值。术中观察８５％的患者上睑提肌弹性良好，肌伸展可达１５～２０ｍｍ。组织学观察发现１７％的患者上睑提肌为正常组织。结论 先天性上睑下垂的发生原因除肌发育不良外，上睑提肌内、外角过度紧张也是其重要因素。并根据病因制定了合理有效的手术方式。Objective To discuss the mechanism of the congenital ptosis. Methods The power, electromyogram ( EMG) , elasticity, anatomy and histology of the levator muscle of upper eyelid in 73 patients (103 eyes) were studied. Results The EMG showed that the mean normal value of contractility of the levator muscles was 500μV/D, the contractility in some patients with muscle weakness (18%) was 260-350 μV/D, near to the normal value, the contractility in other patients with the muscle expansion 3-5 mm(9.99%) reached to the mean normal value.Exami- nation during the operation, the elasticity of the upper eyelid levator muscles in 85% patients was good, the muscle expansion could be 15 - 20 mm. The upper eyelid levator muscles of 17% patients in histology were normal tissue. Conclusion The main factor of this disease was the overtension of the internal and external angles of the levator muscles ex- cept for the muscle maldevelopment. The different reasonable and effec- tive operation methods were designed according to the various causes.

关 键 词：先天性上睑下垂 发病机制 上睑提肌弹性 手术设计 上睑提肌内角 

分 类 号：R777.4[医药卫生—眼科]