条状瘢痕组织瓣悬吊法修复外伤性下睑退缩  

Treatment of traumatic lower eyelid retraction with strip-type scar tissue flap(with video)

作　　者：张畅 吴乐昊 周栩 王佳琦 Zhang Chang;Wu Lehao;Zhou Xu;Wang Jiaqi(Department of Cervicofacial Plastic and Reconstructive Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院面颈整形美容中心,北京100144

出　　处：《中华整形外科杂志》2022年第2期186-190,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨条状瘢痕组织瓣悬吊法修复轻、中度外伤性下睑退缩的临床疗效。方法回顾性分析2017年1月至2020年1月,中国医学科学院整形外科医院面颈整形美容中心收治的轻、中度外伤性下睑退缩患者临床资料。采用手术切除瘢痕的同时制作条状瘢痕组织瓣旋转填补于下睑组织并向内眦或外眦处骨膜固定悬吊下睑。术后随访测量下睑缘位置,观察其变化情况。结果共纳入26例(26只眼),其中男性14例,女性12例,年龄15~67岁,平均38岁,下睑退缩合并颧颊部瘢痕13例、下睑退缩合并上睑瘢痕9例、下睑退缩合并颞部瘢痕4例。26例患者伤口均一期愈合,随访时间6~12个月,术后26例患者下睑退缩均获显著改善,功能正常,下睑无外翻和内翻。术后除1例眼睑轻度闭合不全,3例早期眼干不适外,无严重并发症。结论利用带蒂条状瘢痕组织瓣悬吊法修复外伤性下睑退缩,既可松解瘢痕挛缩,也可利用多余的瘢痕组织悬吊支持退缩下睑,不增加额外的切口,治疗效果确切,实用性强,对于轻、中程度的外伤性下睑退缩是一种较好的手术方法。Objective To introduce a new method of repairing mild to moderate traumatic lower eyelid retraction with strip-type scar tissue flap.Methods From January 2017 to January 2020,patients with both mild to moderate traumatic lower eyelid retraction and periorbital scars were retrospectively summarized.For those patients,whilst the superficial layer of scars were removed and the deep tissue was processed into a strip-type scar tissue flap.The retracted lower eyelid was lifted by suspending the strip-type scar tissue flap to the canthus.Results At total of 26 patients(26 eyes)with traumatic lower eyelid retraction received the surgery,including 14 males and 12 females,aged 15-67 years.Based on the location of scars,patients were divided into 13 cases of lower eyelid retraction combined with zygomatic scars,9 cases with upper eyelid scars and 4 cases with temporal scars.All wounds healed in one stage and the post-operative location of lower eyelid margin was measured.With six to twelve months follow-up,the retraction of lower eyelid was improved significantly,with no ectropion and entropion.There were no serious complications except one case of mild lagophthalmos and three cases of dry eye.Conclusions Characterized by suspending the retracted lower eyelid with inherent scar tissue without additional incision or trauma,the method of utilizing strip-type scar flap is effective and practical for correcting mild to moderate traumatic lower eyelid retraction.

关 键 词：眼睑 眼睑外翻 外科皮瓣 瘢痕 眼外科手术 修复重建 下睑退缩 

分 类 号：R779.6[医药卫生—眼科]