眼轮匝肌后脂肪眶隔瓣修复不良重睑术组织缺损的效果  

Effects of retro-orbicularis oculus fat and orbital septum flap on repairing tissue defect of double eyelid surgery

作　　者：李欣欣 刘育凤[2] 刘宁[2] 陈爽[2] Li Xinxin;Liu Yufeng;Liu Ning;Chen Shuang(Department of Plastic Surgery,Affiliated Hospital of Nanjing University of traditional Chinese Medicine,Nanjing 210029,China;Department of Plastic Surgery,Jiangsu Hospital of Traditional Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院整形外科,210029 [2]江苏省中医院整形外科,南京210029

出　　处：《中华医学美学美容杂志》2020年第4期302-305,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：江苏省中医院科技项目(Y2018CX39)。

摘　　要：目的探讨眼轮匝肌后脂肪眶隔瓣修复不良重睑术后组织缺损的效果。方法2016年3月至2018年7月,江苏省中医院整形外科收治23例不良重睑术女性患者(年龄18~41岁,平均26.3岁),均为重睑切开术后重睑切口区域组织严重缺乏,或伴有不同程度医源性上睑提肌功能障碍,均采用眼轮匝肌后脂肪眶隔瓣术式进行修复;术中发现眼轮匝肌后脂肪眶隔瓣层过于薄弱,以该层组织为载体进行脂肪颗粒注射填充。术后随访3个多月,评估其修复效果。结果23例患者切口均一期愈合,无血肿及感染。2例严重组织缺乏合并重度机械性上睑下垂的病例修复术后仍然存在不同程度的上睑下垂,5例术后患者认为闭眼时存在切口的台阶感;其余16例重睑形态获得不同程度改善。结论松解释放眼轮匝肌后脂肪眶隔瓣能有效防止不良重睑线再次粘连,对于重睑术后组织缺损的修复有较满意效果。Objective To explore the problem of repairing postoperative tissue defect of double eyelid with the retro-orbicularis oculus fat and orbital septum flap.Methods From March 2016 to July 2018,a total of 23 female patients(18-41 years old,average 26.3 years)were treated in the Department of Plastic Surgery,Jiangsu Hospital of Traditional Chinese Medicine.They all had abnormal morphology and severe tissue deficiency in the incision area after blepharoplasty.It was even accompanied by different degrees of iatrogenic levator dysfunction,and they were all repaired by the retro-orbicularis oculus fat and orbital septum flap;if the fat of the posterior orbicularis oculi muscle and orbital septal layer was too"weak"during the operation,the layer was used as the carrier for the granular adipose tissue.Follow-up was conducted for more than 3 months after operation to evaluate the effect.Results All incisions in this group were healed in one stage after operation,without hematoma and infection.Two cases with severe tissue deficiency and severe mechanical blepharoptosis in the pre-operation still had different degrees of ptosis after operation.Five patients had different degrees of ptosis after operation.Five patients had postoperative shape of"step"in the incision when they closed their eyes.The shape of double eyelid was improved in different degree in other beauty seekers.Conclusions Loosing and releasing the retro-orbicularis oculus fat and orbital septum flap can effectively prevent the bad double eyelid line from adhesion,and it has a satisfactory effect for the reconstruction of the serious tissue defect after double eyelid surgery.

关 键 词：眼部 重睑成形术 修复术 眼轮匝肌后脂肪 脂肪颗粒 

分 类 号：R779.6[医药卫生—眼科]