肌皮瓣法重睑术的临床疗效分析  

Clinical efficacy analysis of myocutaneous flap in blepharoplasty

作　　者：文辉才[1] 万珺[1] 眭云鹏 简雪平[1] 马丽[1] 徐桂珍[1] 刘燕平[1] 

机构地区：[1]南昌大学第一附属医院整形美容科,南昌330006

出　　处：《中国修复重建外科杂志》2017年第3期327-330,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的介绍肌皮瓣法重睑术并总结其临床疗效。方法 2013年1月—2016年3月,共1 560例患者行肌皮瓣法重睑术,总结随访达6个月以上的158例患者临床资料。男18例,女140例;年龄18~35岁,平均23.4岁。单侧13例,双侧145例。患者存在不同程度重睑过窄、重睑形态过浅、单睑、上睑臃肿、上睑皮肤松弛。均无重睑整复术史。术中逐层修剪眼轮匝肌至睑板前之间的组织,保留切口下唇眼轮匝肌、肌下毛细血管网和睑板前筋膜,将切口上下缘全层皮肤、肌肉组织及睑板前筋膜进行解剖对位缝合。结果术后158例患者切口均Ⅰ期愈合。患者均获随访,随访时间6个月~2年,平均8.3个月。随访期间,9例(12只眼)重睑线过浅或消失,经小切口重新修剪睑板前组织并缝合后,获得满意效果。其余患者均取得良好效果。重睑形态自然、连贯、持久,切口无明显瘢痕,切缘未见明显凹陷。结论肌皮瓣法重睑术具有恢复快、创伤小、肿胀轻、重睑效果稳定且持久、切口无凹陷、无明显瘢痕等优点。Objective To introduce the myocutaneous flap in blepharoplasty and summarize its clinical efficacy. Methods Between January 2013 and March 2016, 1 560 patients underwent blepharoplasty with myocutaneous flap. Of them, 158 patients were foUowed up over 6 months and included in the study. There were 18 males and 140 females with the average age of 23.4 years （range, 18-35 years）. The unilateral side was involved in 13 cases and bilateral sides in 145 cases. The patients had narrow double eyelid, shallow double eyelid, single eyelid, bloated upper eyelid, and upper eyelid skin relaxation. During operation, the tissue between the orbicular muscle of eye and the tarsus was trimmed layer by layer; the orbicularis oculi muscle, capillary network, and the front fascia of tarsus were retained, and the full-thickness skin, muscle, and the front fascia of tarsus were sutured by anatomical apposition. Results Incision healed at stage I. All patients were followed up 6 months to 2 years （mean, 8.3 months）. During foUow-up period, shaUow or extinctive double- eyelid line was observed in 9 cases （12 eyes）, and satisfactory results were achieved after trimming front fascia of tarsus and suturing. Good clinical results were obtained in the other patients, who had natural and coherent double eyelid without obvious scar or depression at resection margin. Conclusion Myocutaneous flap for blepharoplasty has many advantages of fast recovery, little wound, light swelling, permanent effects, and good appearance.

关 键 词：重睑术 肌皮瓣 临床疗效 

分 类 号：R779.6[医药卫生—眼科] R622[医药卫生—临床医学]