额肌瓣悬吊术与提上睑肌缩短术治疗重度上睑下垂患儿的疗效对比研究  

A Comparative Study of Frontalis Muscle Flap Suspension and Levator Palpebrae Shortening in the Treatment of Severe Blepharoptosis in Children

作　　者：梁晓磊 刘亚丹 吴倩[2] 于刚[2] LIANG Xiao-lei;LIU Ya-dan;WU Qian;YU Gang(Department of Ophthalmology,Beijing New Century Children's Hospital,Beijing 100045,China;Department of Ophthalmology,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]北京新世纪儿童医院眼科,北京100045 [2]首都医科大学附属北京儿童医院眼科,北京100045

出　　处：《中国美容医学》2019年第7期1-4,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:比较额肌瓣悬吊术与提上睑肌缩短术治疗重度上睑下垂患儿的临床疗效。方法:选取2015年5月-2018年5月笔者医院收治的重度上睑下垂患儿104例(157眼),根据手术方式的不同将所有患儿分为额肌瓣悬吊组(n=52例,73眼,采用额肌瓣悬吊术)和提上睑肌缩短组(n=52例,84眼,采用提上睑肌缩短术),比较两组患者临床疗效,泪膜破裂时间(Breakup time of tear film,BUT)、泪液分泌试验(Schirmer test,SIt)、角膜荧光染色(Fluorescent staining,FL)检查结果,观察两组患者术后并发症发生情况。结果:提上睑肌缩短组患者术后临床总有效率为92.86%(78/84)显著高于额肌瓣悬吊组的82.19%(60/73),差异有统计学意义(P<0.05)。两组患者术后7d、术后1个月FL高于术前(P<0.05),两组患者术后3个月FL与术前比较差异无统计学意义(P>0.05);提上睑肌缩短组术后7d、术后1个月、术后3个月SIt、FL与额肌瓣悬吊组比较差异无统计学意义(P>0.05);提上睑肌缩短组术后7dBUT低于额肌瓣悬吊组(P<0.05),而提上睑肌缩短组术后1个月、术后3个月BUT与额肌瓣悬吊组比较差异无统计学意义(P>0.05)。额肌瓣悬吊组并发症发生率为8.22%(6/73),提上睑肌缩短组为3.57%(3/84),差异无统计学意义(P>0.05)。结论:与额肌瓣悬吊术相比,提上睑肌缩短术治疗重度上睑下垂患儿的疗效更为确切,且安全性与其相当,临床可考虑将提上睑肌缩短术作为治疗重度上睑下垂患儿的首选术式。Objective To compare the clinical effects of frontalis muscle flap suspension and levator palpebrae shortening in the treatment of severe blepharoptosis. Methods 104 children (157 eyes) with severe blepharoptosis who were admitted to our hospital from May 2015 to May 2018 were selected,they were divided into frontal muscle flap suspension group (n =52, 73 eyes, frontal muscle flap suspension) and upper eyelid muscle shortening group (n =52, 84 eyes, levator muscle shortening). The clinical efficacy,tear film rupture time (BUT),tear secretion test (SIt) and corneal fluorescence staining (FL) were compared between the two groups.The incidence of postoperative complications in two groups were observed. Results The total effective rate of levator palpebrae shortening group[92.86%(78/84)] was significantly higher than that of frontal muscle flap suspension group[82.19%(60/73)], the difference was statistically significant(P <0.05). FL was higher in the two groups at 7d and 1 month after operation than that before operation (P <0.05). There was no significant difference in FL between the two groups at 3 months after operation (P >0.05). SIt,FL in frontal muscle flap suspension group at 7d,1 month,3 months after operation had no significant difference with upper eyelid muscle shortening group(P >0.05). BUT in levator palpebrae shortening group was lower than that of frontal muscle flap suspension group at 7d after operation, but there was no significant difference in BUT between levator palpebrae shortening group and frontal muscle flap suspension group 1 month and 3 months after operation (P >0.05). There was no significant difference in the incidence of complications between the two groups during the follow-up period(P >0.05). Conclusion Compared with frontalis muscle flap suspension, levator palpebrae shortening is more effective and safe in the treatment of severe blepharoptosis.The shortening of the upper eyelid muscle may be considered as the first choice for the treatment of severe blepharoptosis.

关 键 词：额肌瓣悬吊术 提上睑肌缩短术 重度上睑下垂 患儿 疗效 并发症 

分 类 号：R622[医药卫生—整形外科]