改良结膜上穹窿联合筋膜鞘悬吊及部分提上睑肌复合体缩短术治疗先天性重度上睑下垂  

Modified conjoint fascia sheath suspension combined with partial shortening of levator palpebrae superioris complex in the treatment of congenital severe ptosis

作　　者：晏青 曹川 张家平 王涛 毕胜 袁希 YAN Qing;CAO Chuan;ZHANG Jia-ping;WANG Tao;BI Sheng;YUAN Xi(Department of Plastic Surgery,The Southwest Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院(西南医院)整形外科,重庆400038

出　　处：《中国美容整形外科杂志》2021年第9期545-548,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨改良结膜上穹窿联合筋膜鞘(conjoint fascial sheath,CFS)悬吊、部分上睑提肌(levator muscle,LM)缩短术与单纯CFS悬吊术治疗先天性重度上睑下垂的远期疗效。方法自2017年1月至2020年1月,西南医院整形外科对收治的先天性重度上睑下垂患者126例(220只眼),按手术方法分为两组,对照组68例(104只眼),其中双侧重度36例,一侧重度、另一侧轻中度32例,采用单纯CFS悬吊术。观察组58例(116只眼),均为双侧重度,采用改良CFS悬吊术+LM缩短术。结果随访观察并记录两组患者术后6个月的临床效果。观察组非复发上睑回退(0.51±0.11)mm、上睑形态满意率(96.55%)、眼睑完全闭合率(65.52%)、上睑迟滞发生率(37.93%)、1年复发率(5.17%),对照组非复发上睑回退(1.21±0.19)mm、上睑形态满意率(79.41%)、眼睑完全闭合率(39.42%)、上睑迟滞发生率(86.54%)、1年复发率(21.15%),两组比较其差异有统计学意义(P<0.05)。结论采用改良结膜上穹窿CFS悬吊、部分上睑提肌缩短术矫正先天性重度上睑下垂的手术方法,操作安全,效果较好,并发症较少,患者满意度较高,值得临床推广应用。Objective Toexplore the long-termefficacyofmodified conjoint fascia sheath(CFS)suspension combined with partial shortening of levator muscle(LM)and single CFS suspension in the treatment of congenital severe ptosis.Methods From January 2017 to January 2020,a total of 126 patients(220 eyes)with severe ptosis were collected.All patients were divided into 2 groups according to the surgical methods.There were 68 patients(104 eyes)in the control group,including 36 patients with bilateral severe ptosis,32 patients with severe ptosis on one side and mild to moderate ptosis on the other side.Single CFS suspension was performed in the control group.There were 58 patients(116 eyes)with bilateral severe ptosisin the observation group.The modified CFS suspension and LM shortening was performed in the observation group.Results The clinical efficacy of both groups were observed and recorded at 6 months after operation.In the observation group,the non-recurrent amount of upper eyelid regression was(0.51±0.11)mm,the satisfaction rate of upper eyelid morphology was96.55%,complete eyelid closure rate was 65.52%,incidence rate of upper eyelid hysteresis was 37.93%and recurrence rate of one year was5.17%.In the control group,the non-recurrent amount of upper eyelid regression was(1.21±0.19)mm,the satisfaction rate of upper eyelid morphology was 79.41%,complete eyelid closure rate was 39.42%,incidence rate of upper eyelid hysteresis was(86.54%)and recurrence rate of one year was 21.15%.The difference between 2 groups was statistically significant(P<0.05).Conclusion The modified conjoint fascia sheath suspension combined with partial shortening of levator palpebrae superioris complex is safe and effective in the correction of congenital severe ptosis.The complications are less and patients’satisfaction is high.It should be considerable for clinical promotion and application.

关 键 词：重度上睑下垂 联合筋膜鞘悬吊术 上睑提肌 临床疗效 

分 类 号：R779.6[医药卫生—眼科]