眼轮匝肌部分切除联合眶隔脂肪瓣或眼轮匝肌瓣移植治疗女性外眦角鱼尾纹  

The orbicularis muscle partial resection combined with orbital fat flap or orbicularis muscle flap graft for treatment of crow＇s feet in women

作　　者：陈召伟[1] 刘通[1] 邵景祥[1] 朱童[1] 刘华生[1] 王焕丽[1] Chen Zhaowei Liu Tong Shao Jingxiang Zhu Tong Liu Huasheng Wang Huanli.(Department of Plastic Surgery of Hospital of Liaocheng City Shandong Province, Liaocheng 252000,Chin)

机构地区：[1]山东省聊城市人民医院整形科,252000

出　　处：《中华整形外科杂志》2017年第1期4-7,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨眶部外侧眼轮匝肌部分切除，联合眶隔脂肪瓣或眼轮匝肌瓣移植隔断眶外侧眼轮匝肌，以减轻或消除外眦角鱼尾纹的效果。方法2010年10月至2015年5月，临床治疗82例外眦角鱼尾纹求术者，均为女性，年龄27～54岁。分为新术式组和对照组，每组41例。新术式组采用眶部外侧眼轮匝肌部分切除联合眶隔脂肪瓣或眼轮匝肌瓣移植，隔断眶外侧眼轮匝肌的手术方法；对照组采用传统的手术方法，对出现鱼尾纹的皮肤进行提升处理，或同时对引起鱼尾纹的眼轮匝肌进行提升。统计手术时间、术后恢复时间、术后闭眼功能、血肿和神经损伤等并发症情况。分别于术后1、3、6、12个月由1名对分组不知情的美容医生对治疗效果进行评估，外眼角外上部鱼尾纹消失或明显减少，同时上睑皮肤松弛、外眼角下垂完全纠正为5分；术后没有改善，甚至比术前差为0分。术后12个月随访患者对手术效果的满意情况，分为不满意、较满意和满意。结果82例患者中75例获随访，新术式组39例，对照组36例。手术时间：新术式组为（50±5）min，对照组为（58±4）min；术后拆线时间：新术式组为（5±1）d，对照组为（6．0±1．5）d（P〈0．05）。术后随访2组闭眼功能均良好，无闭眼乏力、困难等现象，亦未见血肿、神经损伤等严重并发症。术后1、3、6、12个月，2组疗效的视觉模拟评分：新术式组分别为3．2±0．6、3．5±0．5、4．2±0．8、4．3±0．8，对照组分别为3．1±0．6、3．4±0．9、3．0±0．6、2．8±0．5，术后6、12个月新术式组明显优于对照组，2组比较差异有统计学意义（P〈0．05）。术后12个月患者满意度调查，新术式组满意33例，较满意4例，不满意2例；对照组满意10例，较满意15例，不满意1I例，2组比较差异有统计学意义（P〈0．05）。结论采用眶部外侧眼轮匝肌Objective To observe the effect of the outer orbicularis muscle partial resection combined with orbital fat flap or orbieularis muscle flap transfer to block orbicularis muscle for improvement of crow＇s feet. Methods From October 2010 to May 2015, 82 cases of females （ aged from 27 to 54 years old） with crow＇s feet were treated with new method（ n =41 ） and traditional method（ control, n =41 ）. The new method included partial resection and orbital fat flap or orbieularis muscle flap transfer to block orbicularis muscle. The traditional method was performed to lift the skin and orbicularis oculi muscle to improve the crow＇s feet. The operation time, the postoperative recovery time, eyes closing function and hematoma, nerve injury and other complications were recorded. 1,3,6 and 12 months after operation, the effect was assessed by one cosmetic surgeon who is unkown the groups. Completely correction was assed as 5 points and no improvement or even worse as 0 point. 12 months after operation, the patients satisfactory rate was recorded. Results 75 cases were followed up, including 39 in new method group and 36 in control group. The operative time and postoperative recovery time were （50 ± 5 ） rain, （58 ± 4） min and （5 ±1） d, （6.0±1.5） d in the new method group and control group respectively （P〈0.05）.The two groups both had good eyes closing function, no eyes dosing fatigue or difficult or other serious complications such as hematoma, nerve injury. Visual analog scale were 3.2 ±0. 6, 3.5 ± 0.5, 4.2 ± 0. 8, 4.3 ± 0.8 and 3.1 ±0.6, 3.4 ±0.9, 3.0 ±0.6, 2.8 ±0.5 in the new method group and control group at 1,3,6,12 months after surgery respectively . Obviously, the effect in new method group was much better than that in control group after 6 and 12 months with statistical significance （ P 〈 0.05 ）. 12 months after surgery, the satisfaction surveys showed satisfactory in 33 cases; fairly satisfactory in 4 cases; dissatisfactory in 2 cases in new method group, and sa

关 键 词：除皱术 鱼尾纹 眼轮匝肌 脂肪瓣 

分 类 号：R779.6[医药卫生—眼科] R622[医药卫生—临床医学]