眼外Check韧带系统的解剖研究  

Anatomical study of the extraocular check ligament system

作　　者：庄纬 范浩 方硕[1] 祝炜烨 陈勇 唐炜雅 杨超[1] 邢新[1] ZHUANG Wei FAN Hao FANG Shuo ZHU Wei-ye CHEN Yong TANG Wei-ya YANG Chao XING Xin(Department of Plastic Surgery, Changhai Hostpital Affiliated to the Second Military Medical University, Shanghai 200433, Chin)

机构地区：[1]第二军医大学附属长海医院整形外科,上海200433 [2]解放军第一一七医院整形外科,浙江杭州310013

出　　处：《中国美容整形外科杂志》2017年第10期577-583,共7页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探索眼部各Check韧带的形态结构、与周围解剖结构的相互关系以及生理功能,为今后改进并推动上穹窿Check韧带悬吊法矫正上睑下垂的临床应用奠定基础。方法对10具中国成年人尸体标本(7具经甲醛固定,3具新鲜)进行解剖研究,其中7对(共14只)眼球进行了离体的大体解剖,3对(共6只)眼球进行了组织学切片的制备,在重点区域进行免疫组化的研究。结果大体解剖发现,提上睑肌-上直肌之间的上穹窿Check韧带向两侧延伸至内、外眦部,与内、外直肌各自的Check韧带存在联系并固定于眶壁,且继续延伸至眼球下方,直至下斜肌与下直肌之间,最终在眼球周围组成了环行的筋膜系统;在部分区域存在平滑肌细胞。结论将这一包绕眼球的环形筋膜样结构命名为"眼外Check韧带系统",推测其在维持结膜穹窿及眼球位置、协调眼球及眼睑的生理运动功能等方面发挥着重要作用。本研究帮助我们更深入地理解上穹窿Check韧带悬吊法矫正上睑下垂的手术原理,对其临床应用及改进提供了参考。Objective To explore the morphological structure of each Check ligament of the eye, the relationship with the surrounding anatomical structure, and the physiological function, and to lay the foundation for the improvement and promotion of the clinical application of this operation. Methods Anatomical study was made of ten Chinese adult cadaver specimens（7 formaldehyde fixation,3 fresh）. Seven pairs（14 orbits） were anatomized in vitro, three pairs（6 orbits） were prepared by histological section. Immunohistochemical study was carried out in key areas. Results Gross anatomy showed that the fornix Check ligament between the upper eyelid muscle and rectus superior extended from both sides to the inner and outer canthus. The fornix Check ligament was linked with each Check ligament of the internal and external rectus and fixed on the orbital wall. The ligament structure continues to extend to the lower part of the eyeball, as far as the inferior oblique muscle and the inferior rectus. This ligament forms a circular fascia system around the eye, along with some smooth muscle cells found in this area. Conclusion This annular fascia structure wrapped around the eye is called the ＂Extraocular Check Ligament System＂. This system plays an important role in maintaining the position of the conjunctiva fornix and the eyeball, and coordinates with the physiological movement ofthe eyeball and eyelids and other functions. This study aids in a better understanding of the surgical principles ofblepharoptosis correction with upper fornix Check ligament suspension, providinga reference for its clinical application.

关 键 词：Check韧带 解剖学 上睑下垂矫正 眼外Check韧带系统 

分 类 号：R622[医药卫生—整形外科] R779.6[医药卫生—外科学]