手术修复眼睑及眶周软组织外伤的美学效果及对血清细胞因子的影响  

Aesthetic repair and effect on serum cytokine in patients with eyelid and periorbital soft tissue trauma

作　　者：王付勇 王卫东 聂顺义 李华强 Wang Fuyong;Wang Weidong;Nie Shunyi;Li Huaqiang(Department of Burn Plastic Wound Repair Surgery,Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院烧伤整形创面修复外科,开封475000

出　　处：《中华眼外伤职业眼病杂志》2023年第7期487-491,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省医学科技攻关计划(LHGJ20191176)。

摘　　要：目的评估眼睑及眶周软组织外伤患者手术修复的美学效果及对血清细胞因子的影响。方法前瞻性队列研究。纳入开封市中心医院2019年1月至2022年1月眼睑及眶周软组织外伤70例(70只眼)为研究对象,患者均接受创面修复手术治疗。分析手术情况及术后血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)浓度变化;随访时间9~45个月,观察眼睑及眶周修复美容效果。结果术后伤口均Ⅰ期愈合。术后7 d,血清IL-1β、TNF-α、IL-8浓度分别为(51.26±3.85)g/L、(7.51±1.58)pg/mL、(6.26±1.98)ng/L,均低于治疗前的(95.67±5.42)g/L、(21.77±3.46)pg/mL、(27.57±3.19)ng/L(t=55.89、31.37、47.49,均P<0.001);随访期间未出现感染、血肿、瘢痕形成、眼睑闭合不全、睑外翻或睑内翻等并发症;末次随访角膜荧光素染色试验为阴性,泪液分泌试验(17.75±1.87)mm/5 min;修复美学效果理想度为100.00%。结论手术修复眼睑及眶周软组织外伤并发症少,恢复快,能控制炎症反应,获得理想修复美学效果。Objective To evaluate the aesthetic efficacy of reconstructive surgery for eyelid and periorbital soft tissue trauma and its effect on cytokines.Methods This was a prospective cohort study.Seventy eyes of 70 patients with eyelid and periorbital soft tissue trauma from Jan.2019 to Jan.2022 in Kaifeng Central Hospital were selected as the study subjects.All patients received wound repair surgery.The operative condition and the concentration changes of serum interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)were analyzed.The efficacy of repair was observed.The follow-up period was 9 to 45 months.Results The wounds healed in stageⅠ.At 7 days after surgery,serum concentration of IL-1β,TNF-αand IL-8 were(51.26±3.85)g/L,(7.51±1.58)pg/mL and(6.26±1.98)ng/L,which were lower than the[(95.67±5.42)g/L,(21.77±3.46)pg/mL,and(27.57±3.19)ng/L]before treatment(t=55.89,31.37,47.49;all P<0.001).During the follow-up time,there were no complications such as infection,hematoma,scar formation,incomplete eyelid closure,ectropion or entropeon.At the last follow-up,the corneal fluorescein staining test was negative,and the tear secretion test was(17.75±1.87)mm/5 min.The ideal degree of aesthetic effect was 100.00%.Conclusion The surgery for repair eyelid and periorbital soft tissue trauma has fewer complications,faster recovery,and can control inflammation and obtain ideal repair aesthetic effect.

关 键 词：眼睑 软组织损伤 眶周 手术 修复 

分 类 号：R779.6[医药卫生—眼科]