不对称双侧先天性上睑下垂的分期手术治疗策略  

Staged Treatment Strategy for Asymmetric Bilateral Congenital Blepharoptosis

作　　者：蒋铮铮 刘菲[2] 汪希[2] 杨群[2] 罗旭松[2] 杨军[2] 

机构地区：[1]杭州美莱医疗美容医院,浙江省杭州市310000 [2]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科杂志》2016年第5期305-308,共4页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨不对称的先天性双侧上睑下垂进行分期手术的治疗策略。方法对2011年至2013年的30例不对称双侧上睑下垂患者进行分期手术矫正。一期手术矫正较重侧（中～重度），行睑板部分切除联合上睑提肌缩短前徙术：3-6个月后再行较轻侧矫正。行睑板部分切除术或上睑提肌缩短术。术后随访3～24个月，术后评估内容包括矫正程度与双侧对称性。结果全部30例患者60只眼，在矫正效果评估中，37（61．7％）只眼为充分矫正，23（38_3％）只眼为中等矫正，无矫正不足或过矫病例。对称性评估中，23（76．5％）例达到良好对称，7（23．5％）例达到中等对称，无对称不佳病例。结论与我们以往的治疗经验相比，对于不对称的双侧先天性上睑下垂，分期手术治疗能够达到更好的对称效果。Objective To explore the staged treatment strategy for asymmetric bilateral congenital blepharoptosis. Methods From 2011 to 2013, 30 cases of asymmetric bilateral congenital blepharoptosis were treated according to the staged strategy. At first stage, severe side （amount of descent over upper limbus： moderate to severe） was treated with levator aponeurosis resection and advancement combined with tarsus resection under general anesthesia. After 3 to 6 months, the contralateral side was treated with tarsus resection or levator aponeurosis resection under local anesthesia. All the patients were followed up for 3 months to 2 years, ptosis correction and bilateral asymmetry were measured. Results In total 60 eyes of 30 cases, sufficient correction was achieved in 37 eyes （61.7%）, moderate correction in 23 eyes （38.3%）. No under correction or overcorrection was observed. As to symmetry evaluation, 23 cases （76.5%） showed good results and 7 cases （23.5%） showed fair results. No poor symmetry was observed. Conclusion Compared to our previous treatment experience, the staged treatment strategy can achieve better symmetry results for asymmetric bilateral congenital blepharoptosis.

关 键 词：上睑下垂 双侧不对称 睑板 

分 类 号：R622[医药卫生—整形外科]