改良CFS悬吊联合提上睑肌缩短术治疗先天性重度上睑下垂  

Application of modified CFS suspension combined with levator muscle resectionin the treatment of severe congenital ptosis

作　　者：王婷 姜艳华 吴海龙 WANG Ting;JIANG Yan-hua;WU Hai-long(Department of Opthalmology,The Fourth People's Hospital of Shenyang,Shenyang 110031,China)

机构地区：[1]沈阳市第四人民医院眼整形美容中心,辽宁沈阳110031 [2]上海美莱美容门诊部整形美容科,上海200050

出　　处：《中国美容整形外科杂志》2021年第9期549-552,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：沈阳市科技计划(20-205-4-051)。

摘　　要：目的观察改良筋膜鞘(conjiont fascial sheath,CFS)悬吊联合提上睑肌缩短术治疗先天性重度上睑下垂的临床效果。方法对自2017年1月至2019年1月就诊于沈阳市第四人民医院眼整形美容中心的30例先天性重度上睑下垂患者,分别采用改良的方法(改良组15例)和传统的方法(传统组15例)进行治疗,并随访观察术后疗效。两组均采用CFS悬吊联合提上睑肌缩短术式进行治疗。但改良法在打开眶隔后,勿切开睑板上缘的提上睑肌腱膜。结果术后患者获随访6~12个月,比较两组术后睑裂高度(palpebral fissure height,PFH)和上睑缘至角膜映光点距离(margin regles distance 1,MRD1)、手术时间、术后并发症的发生率及患者的满意率。30例患者的上睑下垂均得到了较好的矫正,无严重并发症出现。两组的PFH及MRD1比较,其差异无统计学意义(P>0.05)。手术时间:改良组为(38.36±0.49)min,传统组为(46.25±0.51)min,两组比较其差异具有统计学意义(P<0.05)。改良组并发症发生率为4.17%,低于传统组20.83%,其差异具有统计学意义(P<0.05)。患者满意率:改良组为93.33%,传统组为73.33%,改良组明显高于传统组,其差异具有统计学意义(P<0.05)。结论采用改良CFS悬吊术联合提上睑肌缩短术治疗先天性重度上睑下垂,其方法可靠,操作简单,并发症较少,患者满意率较高,值得临床推广应用。Objective To observe the clinical efficacy of modified conjoint fascial sheath(CFS)suspension combined with levator muscle resection in the treatment of severe congenital ptosis.Methods From January 2017 to January 2019,30 patients with severe congenital ptosis were divided into modified group(15 patients)and traditional group(15 patients).These patients were treated by modified method and traditional method,respectively.The postoperative efficacy was observed during the follow-up.The CFS suspension combined with levator muscle resection was performed in both groups.The modified method was to openorbital septum and not to open levator aponeurosis of upper margin of tarsal plate.Results All patients in both groups were followed up for 6 to 12 months.Postoperative palpebral fissure height(PFH),margin regles distance 1(MRD1),operative time,incidence rate of postoperative complications and patients’satisfaction were compared.The ptosis in 30 patients was well corrected without serious complications.There was no significant difference in PFH and MRD1 between 2 groups(P>0.05).The operative time was(38.36±0.49)min in modified group and(46.25±0.51)min in traditional group(P<0.05).The incidence rate of complications was 4.17%in modified group,which was lower than that of20.83%in traditional group(P<0.05).The patients’satisfaction was 93.33%in modified group,which was significantly higher than that of 73.33%in traditional group(P<0.05).Conclusion The modified CFS suspension combined with levator muscle resection is a reliable and simple method in the treatment of severe congenital ptosis.The complications are less and patients’satisfaction is high.It should be considerable for clinical promotion and application.

关 键 词：先天性上睑下垂 提上睑肌 联合筋膜鞘 并发症 改良术式 

分 类 号：R779.6[医药卫生—眼科]