眉下切口提眉术联合重睑成形术治疗中老年中重度上睑下垂的临床体会  

Clinical experience of eyebrow lifting surgery combined with double eyelid plasty in the treatment of moderate and severe ptosis in the elderly

作　　者：葛玉珍[1] 李永立[1] 肖洪波 GE Yu-zhen;LI Yong-li;XIAO Hong-bo(Department of plastic surgery,Jiaozuo Second People's Hospital,Henan Province,454000,China)

机构地区：[1]焦作市第二人民医院整形外科,河南焦作454000

出　　处：《中国医疗美容》2020年第9期66-69,共4页China Medical Cosmetology

摘　　要：目的总结眉下切口提眉术联合重睑成形术治疗中老年中重度上睑下垂的临床经验,探索符合眉眼一体化美学要求及人体生理结构的上睑下垂矫正术。方法 选择2019年1月~2020年3月于我院就诊的42中重度上睑下垂的中老年患者作为研究对象,术前评估去皮总量,先行提眉术,去除眉毛下中外侧多余皮肤,叠加缝合切口上唇肌肉组织瓣固定于预定眉部位置,后行重睑成形术,去除中内侧多余皮肤,去除切口下1条眼轮匝肌,去除疝出眶隔脂肪,缝合固定。结果本组42例患者手术切口均一期愈合,术后14-21d消肿,术后上睑下垂改善明显,上睑皱纹消失,上睑抬高明显,重睑线对称流畅自然,眉形对称,无异常。术后1个月内未见严重并发症。随访3~16个月,42例患者中效果满意40例,基本满意2例。结论 眉下切口提眉术联合以眼轮匝肌缩短、去皮的重睑成形术治疗中重度中老年上睑下垂更符合解剖生理,效果理想,值得临床推广。Objective To summarize the clinical experience of eyebrow lifting combined with blepharoplasty in the treatment of middle-aged and elderly patients with moderate and severe blepharoptosis,and to explore the correction of blepharoptosis in line with the aesthetic requirements of eyebrow and eye integration and human physiological structure.Methods 42 middle-aged and elderly patients with moderate to severe blepharoptosis who were treated in our hospital from January 2019 to March 2020 were selected as the research objects.The total amount of skin removal was evaluated before operation.The extra skin under the eyebrow was removed by eyebrow lifting.The upper lip muscle tissue flap was sutured and fixed at the predetermined eyebrow position.Then double eyelid plasty was performed to remove the medial and medial redundant skin and remove one orbicularis oculi muscle under the incision The herniated orbital septum fat was removed and sutured.Results The incision of 42 patients were healed in the first stage,and the swelling was reduced 14-21 days after operation.The ptosis of upper eyelid was improved obviously,the wrinkles of upper eyelid disappeared,the elevation of upper eyelid was obvious,the double eyelid line was symmetrical and smooth,and the eyebrow shape was symmetrical and normal.No serious complications occurred within 1 month after operation.During the follow-up of 3 to 16 months,40 cases were satisfied with the effect and 2 cases were basically satisfied.Conclusion Under eyebrow incision eyebrow lifting surgery combined with orbicularis oculi muscle shortening and peeling double eyelid plasty in the treatment of moderate and severe ptosis in the elderly is more in line with the anatomy and physiology,the effect is ideal,and it is worthy of clinical promotion.

关 键 词：上睑下垂 中重度 重睑成形术 提眉术 

分 类 号：R779.6[医药卫生—眼科]