皮肤-眼轮匝肌瓣切除术治疗老年性睑板腺功能障碍伴下睑内翻的疗效研究  

Effect of Skin-orbicularis Oculi Muscle Flap Resection in the Treatment of the Elderly with Meibomian Gland Dysfunction and Lower Eyelid Entropion

作　　者：公丕媛 张雪[2] 施小哲[3] GONG Piyuan;ZHANG Xue;SHI Xiaozhe(Department of Ophthalmology and Otolaryngology,Jilin University Hospital,Changchun 130000,Jilin,China;JilinAcademy of Traditional Chinese Medicine,Changchun 130000,Jilin,China;Department of Ophthalmology,the Affi liatedHospital of Changchun University of Traditional Chinese Medicine,Changchun 130021,Jilin,China)

机构地区：[1]吉林大学校医院眼耳鼻喉科,吉林长春130000 [2]吉林省中医药科学院,吉林长春130000 [3]长春中医药大学附属医院眼科,吉林长春130021

出　　处：《中国美容医学》2022年第7期73-77,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究皮肤-眼轮匝肌瓣切除术治疗老年性睑板腺功能障碍(Meibomian gland dysfunction,MGD)伴下睑内翻的美学效果。方法:选择2018年2月-2019年2月于笔者医院接受治疗的老年性睑板腺功能障碍伴下睑内翻患者140例作为研究对象。随机分为观察组及对照组,每组70例。观察组采用皮肤-眼轮匝肌瓣切除术治疗,对照组采用皮肌瓣联合外侧睑板楔形切除术治疗。比较两组治疗后满意度及术后并发症发生情况;对两组睑板相关指标进行比较;比较两组治疗前后角膜荧光素染色(Corneal fluorescein staining,CSF)、泪膜破裂时间(Break-up time,BUT)、泪腺分泌试验(Schirmer’s test,SIT)、眼部疾病指数量表(Ocular surface disease index,OSID)评分;比较两组治疗前后睑裂宽度、泪阜显露率及睫毛朝向水平。结果:观察组治疗后总满意度为85.71%,明显高于对照组的70.00%(P<0.05);治疗后对照组睑板腺脂质分泌情况评分明显高于观察组(P<0.05);观察组治疗后较对照组CSF评分明显降低,BUT评分明显升高(P<0.05);观察组治疗后相比对照组睑裂宽度、泪阜显露率及睫毛朝向水平均明显升高(P<0.05);观察组术后并发症总发生率为10.00%,与对照组的12.86%相比无明显差异(P>0.05)。结论:老年性MGD伴下睑内翻患者使用皮肤-眼轮匝肌瓣切除术治疗效果良好,可有效改善患者睑板功能及睑板形态,提升患者满意度,且并发症少,具有较好的临床意义。Objective To explore the cosmetic effect of skin-orbicularis oculi muscle flap resection in the treatment of the elderly with meibomian gland dysfunction (MGD) and lower eyelid entropion.Methods A total of 140 elderly patients with MGD and lower eyelid entropion who were treated in the hospital from February 2018 to February 2019 were enrolled as the research objects.They were randomly divided into observation group and control group,70 cases in each group.The observation group was treated with skin-orbicularis oculi muscle flap resection,while control group was treated with myocutaneous flap combined with wedge resection of lateral tarsal plate.The satisfaction after treatment,occurrence of postoperative complications,meibomian related indexes,scores of corneal fluorescein staining (CSF),break-up time (BUT),Schirmer’s Test (SIT) and ocular surface disease index (OSID),width of palpebral fissure,exposure rate of lacrimal caruncle and level of eyelash orientation before and after treatment were compared between the two groups.Results The total satisfaction rate after treatment in observation group was significantly higher than that in control group (85.71% vs 70.00%,P<0.05).After treatment,score of meibomian lipid secretion in control group was significantly higher than that in observation group (P<0.05).After treatment,CSF score in observation group was significantly lower than that in control group,while BUT score was significantly higher than that in control group (P<0.05).After treatment,width of palpebral fissure,exposure rate of lacrimal caruncle and level of eyelash orientation in observation group were significantly higher than those in control group (P<0.05).There was no significant difference between observation group and control group in total incidence of postoperative complications (10.00% vs 12.86%,P>0.05).Conclusion The curative effect of skin-orbicularis oculi muscle flap resection is good on elderly patients with MGD and lower eyelid entropion.It can effectively improve meibomian function and mo

关 键 词：睑板腺功能障碍 下睑内翻 皮肤-眼轮匝肌瓣切除术 睑板楔形切除术 老年性 美学效果 

分 类 号：R622[医药卫生—整形外科]