应用眶隔筋膜瓣联合额肌瓣悬吊矫正重度上睑下垂的临床分析  

Clinical analysis of correction of severe blepharoptosis with the orbital musculo-fascial flap and frontalismuscle flap suspension

作　　者：孙玉峰[1] 张芳[1] 王俊河[1] 石英光[1] 

机构地区：[1]郑州大学附属郑州中心医院整形外科,河南郑州450000

出　　处：《中国美容整形外科杂志》2016年第1期27-30,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨眶隔筋膜瓣联合额肌瓣悬吊术在治疗重度上睑下垂中的临床疗效及优势。方法将2010年9月至2014年9月收治的22例（42只眼）重度上睑下垂患者随机分为两组（每组11例），分别采用改良单切口额肌筋膜瓣悬吊术和眶隔筋膜瓣联合额肌瓣悬吊术治疗，并比较其临床疗效。结果术后随访1周，1、3、6个月，22例患者（42只眼）4周内上睑均能完全闭合，重睑外形良好，未发生暴露性角膜炎。改良单切口额肌筋膜瓣组中，1例患者术后欠矫，1例出现上睑内翻，5例上睑迟滞；眶隔筋膜瓣联合额肌瓣悬吊组中，1例术后复发。两组患者中，改良单切口额肌筋膜瓣悬吊术矫正程度略高（P〈0．05）；术后6个月，观察两组疗效差异无统计学意义（P〉0．05）；术后1个月，眶隔筋膜瓣联合额肌瓣悬吊组较单切口额肌筋膜瓣悬吊组术后上睑回缩量明显减少；术后6个月，两组上睑回缩量差异有显著的统计学意义（P〈0．01）。结论两种手术方法均是治疗重度上睑下垂的有效方法，手术安全性高，满意度高。但相对来说，眶隔筋膜瓣联合额肌瓣悬吊术具有并发症少，远期效果较稳定，手术创伤小的优点，值得临床推广应用。Objective To evaluate the clinical efficacy and advantages of the orbital musculo-fascial flap and frontalis muscle flap suspension on correction of severe blepharoptosis. Methods From September 2010 to September 2014, 22 patients aged from 7 to 49 years （2 cases of unilateral, 20 cases of bilateral） with severe ptosis were divided into 2 groups randomly, and then were treated with 2 surgical methods： the modified single- incision frontails muscle suspension and the orbital musculo-fascial flap and frontalis muscle flap suspension. Results The 22 patients （42 eyes） were followed up for lweek to 6 months. All were satisfied with fully clo- sure of the upper eyelid, good contour of double eyelid and no exposure keratitis. There were some complica- tions occurring in the 2 groups, like insufficiency correction （ 1 case） , upper eyelid entropion （ 1 case） and up- per eyelid hysteresis （ 5 cases） in the improved single-incision group and recurrence （ 1 case） in the combined group. The degree of correction in the modified single-incision was little higher than that in the combined group （ P 〈 0.05 ）. There was no statistical significance in the curative effect between the 2 groups at 6 months after operation; The retraction of the upper eyelid in the combined group was more less than that in the modified sin- gle-incision （ P〈 0.01 ） at 1 months after operation; There was statistical significance in the retraction between the 2 groups at 6 months after operation. Conclusion In short, both two surgical methods are the effective methods for correction of severe blepharoptosis with high safety and high satisfaction. Relatively speaking, the combined method has few complications, stable long-term effect and small surgical trauma. It is worthy of posi- tive promotion.

关 键 词：上睑下垂 额肌筋膜瓣 眶隔筋膜瓣 提上睑肌腱膜 

分 类 号：R622[医药卫生—整形外科]