眶隔筋膜瓣结合额肌瓣悬吊术治疗重度上睑下垂的疗效及对屈光状态的影响  

Effect of Orbital Septal Fascial Flap Combined with Frontal Muscle Flap Suspension in the treatment of severe ptosis and its influence on the refractive state

作　　者：汪辉 胡春明 何艳楠 周燕 胡道玲 WANG Hui;HU Chun-ming;HE Yan-nan;ZHOU Yan;HU Dao-ling(Department of Ophtalmology,Xinshijie Yuzhong Eye Hospital of Chongqing City,Chongqing 400015,China;Department of Ophtalmology,Southwest Hospital Affiliated to the Army Military Medical University,Chongqing 400038,China;Department of Ophtalmology,Chongqing Red Cross Hospital,Chongqing Jiangbei District People's Hospital,Chongqing 400023,China)

机构地区：[1]重庆新视界渝中眼科医院眼科,重庆400015 [2]陆军军医大学附属西南医院眼科,重庆400038 [3]重庆市红十字会医院重庆市江北区人民医院眼科,重庆400023

出　　处：《中国美容医学》2019年第3期50-53,共4页Chinese Journal of Aesthetic Medicine

基　　金：西南医院院管课题(编号:SWH2016BZGFKJ-11)

摘　　要：目的:探讨眶隔筋膜瓣结合额肌瓣悬吊术对重度上睑下垂的远期疗效及屈光状态的影响。方法:选取2016年8月-2017年8月笔者医院收治的重度上睑下垂患者84例(128眼),随机分为两组,对照组应用单切口额肌筋膜瓣悬吊术治疗,研究组应用眶隔筋膜瓣联合额肌瓣悬吊术治疗。比较两组矫正率、上睑回缩量及双侧眼睑对称程度。结果:两组总矫正率比较(100.0%vs98.4%),差异无统计学意义(P>0.05),但研究组完全矫正率为75.0%明显多于对照组的56.3%,差异有统计学意义(P<0.05)。术后6个月,研究组患者的上睑回缩量明显低于对照组[(0.16±0.02)mm vs (0.41±0.03)mm,P<0.05];研究组患者的上睑缘恢复对称程度、上睑缘形态及眼睑闭合程度均优于对照组,差异有统计学意义(P<0.05)。两组患者的角膜屈光度和角膜散光度比较,差异无统计学意义(P>0.05)。结论:在针对重度上睑下垂的治疗过程当中,应用眶隔筋膜瓣联合额肌瓣悬吊术的治疗效果理想,临床上应当进一步推广应用。Objective To investigate the effect of orbital septum fascial flap combined with frontal muscle flap suspension on severe ptosis and the influence of refractive state. Methods From August 2016 to August 2017, 84 patients (128 eyes) with severe blepharoptosis were randomly divided into two groups. The control group was treated with single incision frontalis myofascial flap suspension. The study group was treated with orbital septum fascial flap combined with frontalis muscle flap suspension. Results There was no significant difference in the total correction rate between the two groups (P >0.05), but the complete correction rate in the study group was significantly higher than that in the control group (75.0% vs 56.3%,P <0.05). At 6 months after operation, the upper eyelid retraction of the study group was significantly lower than that of the control group [(0.16±0.02)mm vs (0.41±0.03)mm,P <0.05). The symmetry of upper eyelid margin, shape of upper eyelid margin and closure of eyelid in the study group were better than those in the control group (P<0.05). There was no significant difference in corneal diopter and corneal astigmatism between the study group and the control group (P>0.05). Conclusion In the treatment of severe blepharoptosis, orbital septum fascial flap combined with frontalis muscle flap suspension is an ideal method, which should be further popularized in clinic.

关 键 词：重度上睑下垂 单切口额肌筋膜瓣悬吊术 眶隔筋膜瓣联合额肌瓣悬吊术 屈光 散光 上睑回缩量 

分 类 号：R622[医药卫生—整形外科]