小切口联合筋膜鞘悬吊术治疗先天性重度上睑下垂的效果  

Clinical efficacy of small incision conjoint fascial sheath suspension in treatment of severe congenital blepharoptosis

作　　者：韩锋 慕生枝[1] 孙要文[1] 王国栋[1] Han Feng;Mu Shengzhi;Sun Yaowen;Wang Guodong(Department of Burn Plastic and Cosmetic Surgery,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院烧伤整形医学美容外科,西安710068

出　　处：《中华医学美学美容杂志》2023年第4期284-287,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的:探讨小切口入路联合筋膜鞘(CFS)悬吊术治疗先天性重度上睑下垂的效果,并与常规CSF悬吊术比较优缺点。方法:2020年2月至2022年8月,陕西省人民医院烧伤整形医学美容外科将40例(男17例、女23例,年龄18~40岁,平均33.3岁)重度上睑下垂患者分为观察组(22例,38只患眼)、对照组(18例,35只患眼);观察组行小切口CFS悬吊术矫正,对照组常规CFS悬吊术矫正,比较两组术后不同时间矫正效果、并发症、恢复时间等情况。结果:术后7 d及1、3、6个月随访,两种手术方式在各时间点矫正效果差异无统计学意义(均P>0.05)。观察组在各时间点并发症分别为10例(26.3%)、6例(15.7%)、4例(10.5%)、2例(5.2%),而对照组并发症发生率为21例(60.0%)、7例(20.0%)、5例(14.2%)、3例(8.6%),术后7 d两组并发症发生率比较差异有统计学意义(χ^(2)=8.74,P=0.011);6个月随访发现手术切口瘢痕增生,观察组9.1%(2/22)较对照组16.7%(3/18)减低(χ^(2)=0.02,P=0.878),差异无统计学意义。结论:小切口CFS悬吊术治疗中重度上睑下垂有矫正效果满意、损伤范围小、术后并发症少等优点,但术区暴露范围小、操作难度高,对手术医师要求较高。Objective To analyze the clinical effect of small incision approach conjoint fascial sheath(CFS)suspension in the treatment of congenital severe blepharoptosis,and to discuss its advantages and disadvantages compared with conventional CSF suspension.Methods From February 2020 to August 2022,42 cases of severe blepharoptosis in the Department of Burn,Plastic and Cosmetic Surgery,Shaanxi Provincial People's Hospital were divided into the observation group(23 cases,39 eyes)and the control group(19 cases,37 eyes).The observation group was treated with small incision CFS suspension surgery,while the control group was treated with conventional CFS suspension surgery.The correction effect,complications,recovery time and other conditions between the two groups at different times after surgery were compared.Results During postoperative follow-up at 1 week,1 month,3 months,and 6 months,there was no significant difference in the corrective effect between the two surgical methods at each time point(all P>0.05).The incidence of complications in the observation group at each time point that was 26.3%,15.7%,10.5%,and 5.2%,respectively,while the incidence of complications in the control group was 60.0%,20.0%,14.2%,and 8.6%,with statistical differences in the first week after surgery(χ^(2)=8.74,P=0.011).The average postoperative swelling time in the observation group was 4.2 days,which was less than 5.8 days in the control group.During a 6-month follow-up,it was found that there was a decrease in scar hyperplasia in the observation group of 9.1%(2/22)compared to the control group of 16.7%(3/18)(χ^(2)=0.023,P=0.878).The difference was of no statistical significance.Conclusions CFS suspension with small incision in the treatment of moderate and severe blepharoptosis has the advantages of ideal correction effect,small damage range,and few postoperative complications,but the operation area is small,the operation is difficult,and the surgeon has higher requirements.

关 键 词：眼睑 重度上睑下垂 联合筋膜鞘悬吊术 小切口 临床效果 

分 类 号：R779.6[医药卫生—眼科]