联合筋膜鞘悬吊协同上睑提肌缩短法治疗先天性重度上睑下垂的效果  

Combination of conjoint fascia sheath suspension and levator palpebrae superioris shortening for treatment of congenital severe blepharoptosis

作　　者：陈林海 林光豪 魏鹏[1] 唐梦丹[3] 吴昌炎 Chen Linhai;Lin Guanghao;Wei Peng;Tang mengdan;Wu Changyan(Department of Plastic,Repair and Reconstructive Surgery,Ningbo First Hospital,Ningbo 315000,China;Department of Cosmetic Surgery,Shaoxing Women and Children's Hospital,Shaoxing 312000,China;Department of Dermatology,Taizhou First People's Hospital,Taizhou 318020,China;Shanghai Qianmei Medical Cosmetic Hospital,Shanghai 201103,China)

机构地区：[1]宁波市第一医院整形修复重建外科,宁波315000 [2]浙江绍兴市妇幼保健院医疗美容科,绍兴312000 [3]浙江台州市第一人民医院皮肤科,台州318020 [4]上海千美医疗美容医院,上海201103

出　　处：《中华医学美学美容杂志》2022年第6期484-487,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨联合筋膜鞘悬吊协同上睑提肌缩短法对先天性重度上睑下垂的治疗效果。方法2014年6月至2018年12月,宁波市第一医院整形修复重建外科和绍兴市妇幼保健院医疗美容科共收治30例(40眼)先天性重度上睑下垂患者,男21例28眼、女9例12眼;年龄11~35岁,平均17.5岁;单眼20例,双眼10例。均用联合筋膜鞘悬吊协同上睑提肌缩短法进行矫正。术后6个月,测量上睑缘中点到角膜反光点距离(MRD),评估上睑下垂的矫正效果;通过Likert评分量表评估上睑外观的改善情况;统计并发症的发生率。结果术后30例(40眼)随访6~12个月。术前MRD(0.10±0.05)mm,术后MRD(3.80±0.55)mm,差异有统计学意义(t=0.95,P<0.05);其中38眼(95%)矫正,2眼(5%)欠矫。术前评分(0.50±0.05)分,术后(3.80±0.55)分,差异有统计学意义(t=0.98,P<0.05)。术后1例因闭眼不全早期护理不当导致暴露性角膜炎,予以封眼结合药物保守治疗后痊愈。结论联合筋膜鞘悬吊协同上睑提肌缩短法治疗重度上睑下垂效果显著,具有操作简单、手术创伤小、复发率低、并发症发生率低、患者满意度高等优点,值得临床应用。Objective To investigate the therapeutic effect of conjoint fascia sheath suspension and levator palpebrae muscle shortening on congenital severe blepharoptosis.Methods From June 2014 to December 2018,30 cases(40 eyes)of congenital severe ptosis were treated in Ningbo First Hospital and Shaoxing Women and Children's Hospital.All patients were corrected by conjoint fascia sheath suspension and levator palpebrae muscle shortening.Six months after operation,the distance between the middle point of upper eyelid margin and corneal reflex point was measured to evaluate the correction effect of blepharoptosis;the improvement of upper eyelid appearance was evaluated by 5-point Likert scale(LS),and the incidence of complications was counted.Results Thirty patients(40 eyes)were followed up for 6-12 months.Correction effect showed that preoperative marginal reflex distance(MRD)was(0.10±0.05)and postoperative MRD was(3.80±0.55);the difference was statistically significant(t=0.95,P<0.05);38 eyes(95%)were corrected and 2 eyes(5%)were undercorrected;appearance of upper eyelid showed that preoperative LS was(0.50±0.05)and postoperative LS(3.80±0.55);the difference was statistically significant(t=0.98,P<0.05).Only one case was complicated with keratitis caused by improper early nursing after incomplete closure exposure,and the patient was cured by sealing the eyes combined with drug conservative treatment.Conclusions Combined conjoint fascial sheath suspension and levator palpebrae shortening in the treatment of severe blepharoptosis has significant effect,with the advantages of simple operation,small surgical trauma,low recurrence rate,low incidence of complications,high predictability of surgical results and high satisfactory rate of patients.

关 键 词：眼睑成形术 上睑下垂 联合筋膜鞘 上睑提肌 悬吊术 

分 类 号：R779.6[医药卫生—眼科]