联合筋膜鞘+提上睑肌复合瓣悬吊术治疗上睑下垂患儿临床应用研究  

Clinical Application of Combined Fascia Sheath and Levator Palpebrae Muscle Composite Flap Suspension Surgery for the Treatment of Blepharoptosis in Children

作　　者：崔迎欣 孟克青 蔺琪[3] 吴霞 CUI Yingxin;MENG Keqing;LIN Qi;WU Xia(Department of Ophthalmology,Beijing Nuclear Industry Hospital,Beijing 102413,China;Department of Ophthalmology,Hebei Provincial Eye Hospital,Xingtai Hebei 054000,China;Department of Ophthalmology,Beijing Chindren's Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]北京核工业医院眼科,北京102413 [2]河北省眼科医院眼科,河北邢台054000 [3]首都医科大学附属北京儿童医院眼科,北京100045

出　　处：《中国卫生标准管理》2023年第17期9-13,共5页China Health Standard Management

基　　金：邢台市重点研发计划自筹项目(2021ZC066)。

摘　　要：目的观察联合筋膜鞘+提上睑肌复合瓣(combined fascial sheath and levator,CFS+L)悬吊术治疗上睑下垂患儿的疗效,通过图像模拟处理研究分析上睑下垂患儿术后预期效果与临床意义。方法筛选2018年12月—2022年6月就诊于北京核工业医院住院部符合纳入标准的先天性重症上睑下垂患儿15例(27眼),均予以CFS+L悬吊术治疗,观察周期为6个月。分别于术后1、3、6个月时观察并比较患儿矫正率、泪膜分布、上睑迟滞和眼睑闭合不全情况,以及上睑缘高度(margin reflex distance,MRD)、眼睑高度、眼睑闭合不全量及眼睑上睑回退情况;并对比术前图像处理的预期效果与实际术后外观效果,评估人工智能图像处理的临床意义。结果与术后1、3个月比较,术后6个月的适矫率最佳(P<0.05);术后6个月患儿泪膜分布情况明显优于术后1、3个月,且上睑迟滞及眼睑闭合不全情况较术后1、3个月明显好转;术后6个月的MRD和眼睑高度显著上调,上睑回退和眼睑闭合不全量显著下调,差异有统计学意义(P<0.05)。与术后6个月比较,人工智能图像处理的预期图像MRD和眼睑高度有上调趋势,上睑回退和眼睑闭合不全量有下调趋势,但差异无统计学意义(P>0.05);96.29%患儿认为人工智能图像处理对预测术后外观有用,88.89%患儿认为预期图像与实际术后外观相似。结论CFS+L悬吊术治疗先天性重度上睑下垂效果良好,具有治愈率高、效果稳定的特点,在术前应用人工智能图像处理能够简单快捷并准确地预测矫正后的预期效果,提供患儿直观的术后疗效。Objective To observe the effect of combined fascial sheath and levator(CFS-L) palpebrae muscle complex flap suspension in the treatment of children with ptosis.To analyze the expected results and clinical significance of postoperative ptosis in children with artificial intelligence image processing.Methods A total of 15 children(27 eyes) with congenital severe blepharoptosis who met the inclusion criteria in the inpatient department of Beijing Nuclear Industry Hospital from December 2018 to June 2022 were screened,and all received CFS+L suspension surgery(combined fascia sheath + levator palpebral muscle compound flap suspension) treatment,the observation period was 6 months.The correction rate,tear film distribution,upper eyelid retardation and incomplete eyelid closure,as well as MRD,eyelid height,incomplete eyelid closure,and upper eyelid retraction at 1 month,3 months and 6 months after surgery were observed and compared,and the expected effect of preoperative image processing with the actual postoperative appearance effect,and evaluate the clinical significance of artificial intelligence image processing were compared.Results Compared with 1 and 3 months after operation,the rate of proper correction was the best at 6 months after operation(P<0.05);the tear film distribution of children at 6 months after operation was significantly better than that at 1 and 3 months after operation,and the upper eyelid was delayed and eyelid insufficiency was significantly improved compared with 1 and 3 months after surgery;the MRD and eyelid height were significantly increased at 6 months after surgery,and the amount of upper eyelid retraction and eyelid insufficiency was significantly decreased,the difference was statistically significant(P<0.05).Compared with 6 months after surgery,the expected image MRD and eyelid height of artificial intelligence image processing showed an upward trend,and the amount of upper eyelid regression and incomplete eyelid losure had a downward trend,but the difference was not statistically sign

关 键 词：先天性上睑下垂 患儿 眼睑闭合不全 CFS+L悬吊术 矫正 智能图像处理 

分 类 号：R622[医药卫生—整形外科]