联合筋膜鞘悬吊术矫正修复上睑下垂手术失败的原因与修复方式  

Effect of combined fascial sheath suspension in treatment of blepharoptosis failure

作　　者：刘萍 刘毅 宋玫 杨福秀 李晓晓 汪引平 李艳 Liu Ping;Liu Yi;Song Mei;Yang Fuxiu;Li Xiaoxiao;Wang Yinping;Li Yan(Burn and Plastic Surgery Center,the 940th Hospital of the Joint Logistic Support Force of PLA,Lanzhou 730050,China)

机构地区：[1]解放军联勤保障部队第940医院烧伤整形科,兰州730050

出　　处：《中华医学美学美容杂志》2023年第6期448-451,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的分析联合筋膜鞘(conjoint fascial sheath,CFS)悬吊术矫正上睑下垂术失败的原因与修复方式。方法2021年9月至2022年9月,解放军联勤保障部队第940医院烧伤整形科对CFS悬吊术失败的13例(男5例、女8例,年龄19~49岁,平均25岁)患者18只眼,分别用提上睑肌缩短术、CFS悬吊术、额肌瓣悬吊术进行修复,并观察手术效果。结果CFS悬吊术矫正上睑下垂失败的原因分别为对CFS的解剖不熟悉、缝合固定不牢靠、CFS发育不良与缝合部位不当等。13例18只眼修复术后随访6~30个月,2例未完全矫正,由重度矫正为轻度上睑下垂;2例复发,6个月后再次行额肌瓣悬吊术矫正至正常;其余患者上睑下垂矫正良好,手术效果满意。结论根据患者的眼睛情况掌握适应证,熟悉局部解剖和精准的手术操作是成功的关键。Objective To analyze the failure causes and repair methods of conjoint fascial sheath(CFS)suspension in ptosis correction.Methods From 2021 September to September 2022,13 cases(5 males and 8 females,aged from 19 to 49 years with an average of 25 years)were collected,and there were 18 eyes of CFS suspension in the Department of Burn and Plastic Surgery Center,the 940th Hospital of the Joint Logistic Support Force of PLA with a failed ptosis surgeries,including levator palpebrae superioris muscle shortening,CFS suspension,and frontalis muscle suspension.Results Among the 13 patients(18 eyes),the failure causes included a result of the unfamiliar anatomy of CFS,unstable suture fixation,dysplasia of CFS,and improper suture site,CFS suspension failed to correct ptosis.After following-up for 6 to 30 months after reconstructive surgery,14 eyes were corrected satisfactorily,2 eyes were relieved of ptosis,and 2 eyes had ptosis recured six months after restorative surgery and a frontalis muscle suspension was used in the recured cases with a satisfactory outcome.Conclusions According to the patient′s eye condition,mastering the indications,be familiar with the local anatomy and accurate surgical procedures are the key to success.

关 键 词：重度上睑下垂 修复 联合筋膜鞘 悬吊术 额肌瓣悬吊术 

分 类 号：R779.6[医药卫生—眼科]