额肌瓣悬吊术在上睑下垂矫正中的应用效果  

Applicative Effect of Frontal Muscle Flap Suspension in the Ptosis Correction

作　　者：邬天刚[1] 

机构地区：[1]汉中市人民医院整形外科,陕西汉中723000

出　　处：《医学综述》2016年第17期3527-3530,共4页Medical Recapitulate

摘　　要：目的观察额肌瓣悬吊术在上睑下垂矫正中的应用效果。方法回顾性分析2012年7月至2013年7月汉中市人民医院收治的上睑下垂病历资料,采用额肌瓣悬吊术治疗患者作为观察组(27例)。采用上睑提肌缩短术患者作为对照组(36例)。比较两组患者术后1、3、5、10 d泪液浸润湿长10 mm试纸所需的时间、泪膜破裂时间、角膜荧光素染色评分、结膜充血评分、睫毛角度轻微异常、障碍性睑板腺功能、测量瞬目的次数。观察近期疗效及术后并发症发生情况。结果两组术后1、3、5、10 d泪液浸润湿长10 mm试纸所需时间、角膜荧光素染色及结膜充血评分、轻微异常性上睑睫毛角度及异常的睑板腺眼数、在组间、不同时点间、组间·不同时点间交互效应比较差异无统计学意义(P>0.05)。两组术后1、3、5、10 d泪膜破裂时间均呈上升趋势,对照组始终高于观察组,尤其是术后10 d,对照组的泪膜破裂时间长于观察组[(11.21±0.74)s比(8.21±0.49)s];两组术后1、3、5、10 d眼睑闭合不全距离均呈下降趋势,观察组始终短于对照组,尤其是术后10 d,观察组的眼睑合并不全为(1.41±0.21)mm,短于对照组的(2.47±0.45)mm;两组术后1、3、5、10 d瞬目次数均呈上升趋势,观察组始终多于对照组,尤其是术后10 d,观察组的瞬目次数(15.02±1.32)次/min多于对照组(10.02±1.21)次/min,两组在组间、不同时点间、组间·不同时点间交互效应比较差异有统计学意义(P<0.05)。观察组患者的矫正良好率[70.37%(19/27)]显著高于对照组[16.67%(6/36)](P<0.05)。观察组和对照组的并发症发生率分别为51.85%(14/27)、50.00%(18/36),两组之间比较差异无统计学意义(P>0.05)。结论上睑下垂患者采用额肌瓣悬吊术进行矫正,对于重度上睑下垂患者而言,效果更为明确。Objective To study the applicative effect of frontal muscle flap suspension in the ptosis cor- rection. Methods Total of 27 patients treated with frontal muscle flap suspension surgery in Hanzhong Peo- ple＇s Hospital from Jul. 2012 to Jul. 2013 were included as the observation group and 36 ptosis patients treated with upper eyelid shortening operation were included as the control group, their clinical records were ret- rospectively analyzed. The tear infiltration 10 mm time, tear film rupture time, corneal fluorescein staining score, conjunctival congestion score, cases of slightly abnormal eyelash angle, obstacle of function of the mei- bomian gland, and measured blink times of the two groups at 1,3,5,10 d after surgery were compared. The short-term efficacy and postoperative complications were observed. Results The differences of tears infiltration 10 mm time, corneal fluorescein staining and conjunctival congestion score, mild abnormal upper eyelash angle and abnormal meibomian gland eye number at postoperative 1,3,5,10 d, between groups, between different time points, between groups · different time points interaction had no statistically significant differences （ P 〉0. 05）. Tear film rupture time of both groups at postoperative 1,3,5,10 d were on the rise,and the control group was always higher than the observation group, especially at 10 d after surgery, the control groupwas longer than the observation group [ （ 11.21 ± 0. 74） s vs （8.21 ± 0. 49 ） s ]. The hypophasis distances of both groups at postoperative 1,3,5,10 d were declining,and the observation group was always shorter thanthe control group ,especially after 10 d ,the observation group＇s hypophasis distance was shorter than the control group[ （1.41 ± 0. 21 ）mm vs （2.47 ±0. 45） mm]. Blink times of the two groups at postoperative 1,3,5, 10 d were on the rise, and the observation group was always more than the control grnup,especially after 10 d [ （ 15.02 ± 1.32） times/min vs （ 10. 02 ± 1.21 ） times/mini ,the d

关 键 词：上睑下垂 额肌瓣悬吊术 矫正 

分 类 号：R779.64[医药卫生—眼科]