联合筋膜鞘悬吊术和提上睑肌缩短术治疗儿童中重度上睑下垂疗效对比  

Comparison of the Effects of Conjoint Fascial Sheath Suspension and Levator Muscle Resection in the Clinical Treatment of Children with Moderate to Severe Ptosis

作　　者：李雯[1] 谢琳辉 杨慧玲[1] LI Wen;XIE Linhui;YANG Huiling(Department of Ophthalmology,Hunan Children's Hospital,Changsha 410007,Hunan,China)

机构地区：[1]湖南省儿童医院眼科,湖南长沙410007

出　　处：《中国美容医学》2022年第8期67-70,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:比较联合筋膜鞘悬吊术(Conjoint fascial sheath suspension,CFSS)和提上睑肌缩短术(Levator muscle resection,LMR)在儿童中重度上睑下垂患儿临床治疗中的效果。方法:2020年1月-2021年12月在笔者医院行手术治疗的55例(74只眼)中重度上睑下垂患儿,按手术方案的不同分为两组,CFSS组35例(51眼),LMR组20例(23眼)。对比两组矫正效果、泪液分泌试验(Schirmer I test,SIT)、泪膜破裂时间(Break-up time,BUT)、角膜荧光素染色(Fluorescein staining,FL)评分、上睑回退量、上睑活动范围、并发症发生情况。结果:CFSS组正矫率98.04%高于LMR组82.61%(P<0.05)。术后两组的SIT、BUT较术前差异无统计学意义(P>0.05),术后两组的FL评分较术前高(P<0.05),且术后CFSS组的FL评分较LMR组低(P<0.05)。术后12周两组的上睑回退量较术后4周少(P<0.05),上睑活动范围较术后4周大(P<0.05);术后4周、术后12周,CFSS组的上睑回退量较LMR组少(P<0.05),上睑活动范围较LMR组大(P<0.05)。CFSS组的并发症总发生率9.80%,较LMR组34.78%低(P<0.05)。结论:与LMR相较,CFSS用于治疗中重度上睑下垂患儿的矫正效果更好,在减轻角膜损害、减少上睑回退量、扩大上睑活动范围方面效果更显著,且并发症发生率低。Objective To compare the clinical effectiveness of conjoint fascial sheath suspension(CFSS)and levator muscle resection(LMR)in the clinical treatment of children with moderate to severe ptosis.Methods From January 2020 to December 2021,55 children(74 eyes)with moderate to severe ptosis who underwent surgery in our hospital were separated into two groups according to different surgical plans,35 cases(51 eyes)in the CFSS group were treated with CFSS;20 cases(23 eyes)in the LMR group were treated with LMR.The correction effect,tear secretion test(SIT),tear film break-up time(BUT),corneal fluorescein staining(FL)score,upper eyelid retraction,upper eyelid range of motion,and complications were compared between the two groups.Results The correction rate of CFSS group 98.04%was higher than LMR group,82.61%(P<0.05).There was no significant difference in SIT and BUT between the two groups after operation(P>0.05),the FL score of the two groups after operation was higher than before operation(P<0.05),and the FL score of the CFSS group after operation was lower than the LMR group(P<0.05).At 12 weeks after operation,the retraction of upper eyelid in the two groups was less than that at 4 weeks after operation(P<0.05),and the range of upper eyelid motion was larger than that at 4 weeks after operation(P<0.05),at 4 weeks and 12 weeks after operation,the upper eyelid retraction in the CFSS group was less than the LMR group(P<0.05),and the upper eyelid range of motion was larger than the LMR group(P<0.05).The total incidence of complications in the CFSS group was 9.80%,which was lower than LMR group 34.78%(P<0.05).Conclusion Compared with LMR,CFSS has better correction effect in the treatment of children with moderate to severe ptosis,and is more effectual in reducing corneal damage,reducing the amount of upper eyelid retraction,and expanding the range of motion of the upper eyelid,and complication rate is low.

关 键 词：联合筋膜鞘悬吊术 提上睑肌缩短术 儿童 中重度上睑下垂 效果 

分 类 号：R622[医药卫生—整形外科]