改良眼轮匝肌蒂皮瓣联合上睑皮肤松弛矫正术修复较大睑黄瘤术后缺损  

Clinical experience of modified orbicularis oculi muscle pedicle flap for repairing the defect of larger eyelid xanthoma

作　　者：程茜 张勇[1] 杨巧飞 李力群[2] Cheng Xi;Zhang Yong;Yang Qiaofei;Li Liqun(Department of Plastic Surgery,First Hospital of Taizhou,Taizhou 318020,China;First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]台州市第一人民医院整形美容科,318020 [2]温州医科大学附属第一医院整形美容科,325000

出　　处：《中华整形外科杂志》2020年第12期1331-1334,共4页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金(81971850)。

摘　　要：目的探讨改良后的眼轮匝肌蒂皮瓣联合上睑皮肤松弛矫正术一期修复较大睑黄瘤切除术后上睑前层缺损的方法和效果。方法2018年6月至2020年6月,台州市第一人民医院整形美容科收治上睑较大睑黄瘤患者14例共23只眼,年龄41~68岁,平均52岁。根据睑黄瘤位置和上睑皮肤松弛情况设计2条重睑线,以标记拟切除组织。彻底切除睑黄瘤,根据缺损大小,将拟切除组织设计成以上方眼轮匝肌为蒂的皮瓣,推进修复缺损,最后行重睑成形术。观察术后效果。结果术后14例23只眼皮瓣均成活,均获3~24个月随访,见皮瓣色泽、质地正常,无明显臃肿,术区切口瘢痕不明显,重睑形态自然,效果满意。无一例患者肿瘤复发。结论利用上睑松弛组织设计以上方眼轮匝肌为蒂的改良皮瓣联合上睑皮肤松弛矫正术进行修复,可修复上睑较大睑黄瘤切除后的眼睑前层缺损,操作简便、成活率高,在确切去除病灶、减少复发的同时,改善眼睛形态、避免皮瓣术后臃肿等并发症。Objective To explore the application effect of the improved pedicled orbicularis oculi flap transplantation combined with blepharochalasis correction for one-stage repairing eyelid anterior defect after resection of large xanthoma.Methods From June 2018 to June 2020,14 patients with 23 cases of eyelid anterior large xanthoma were treated,two double eyelid lines were designed according to the location of xanthoma and the laxity of upper eyelid skin,to mark the tissue to be removed.Remove xanthoma thoroughly,design the pedicled flap based on superior orbicular is oculi muscle defect coverage,along with double eyelid operation.Results Satisfactory results were obtained in 14 patients with 23 eyes by this method.Conclusions The application of orbicularis oculi pedicled flap can solve the problem of repairing eyelid anterior defect after resection of large xanthoma.The operation method has value for clinical practice.

关 键 词：外科皮瓣 眼睑肿瘤 上睑皮肤松弛 

分 类 号：R779.6[医药卫生—眼科]