双W形皮肤-结膜贯穿连续埋线法重睑术的临床应用  

Clinical application of double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva

作　　者：朱绪国[1] 徐登成 张秀云[1] 盛旭东 田博 杨建絮[3] 郭丽娟 Zhu Xuguo;Xu Dengcheng;Zhang Xiuyun;Sheng Xudong;Tian Bo;Yang Jianxu;Guo Lijuan(Department of Medical Aesthetic Surgery,People’s Hospital of Rizhao,Rizhao 276800,China;Department of Endocrinology,People’s Hospital of Rizhao,Rizhao 276800,China;Outpatient Operating Room,People’s Hospital of Rizhao,Rizhao 276800,China;Department of Plastic Surgery,Yimeitiancheng’s Cosmetic and Plastic Hospital of Rizhao,Rizhao 276800,China)

机构地区：[1]日照市人民医院医疗美容科,日照276800 [2]日照市人民医院内分泌科,日照276800 [3]日照市人民医院门诊手术室,日照276800 [4]日照壹美天成美容整形医院整形科,日照276800

出　　处：《中华整形外科杂志》2023年第12期1344-1348,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨双W形皮肤-结膜贯穿连续埋线法重睑术的临床应用效果。方法回顾性分析2021年1月至2022年6月于日照市人民医院医疗美容科、日照壹美天成美容整形医院整形科行双W形皮肤-结膜贯穿连续埋线法重睑术的患者资料。术前设计重睑线并均匀标记5点,从外向内依次为A、B、C、D、E点。术中用10 ml针头对重睑线上标记的5点破皮,由最外侧的A点皮面斜向内侧进针,翻转上睑,睑板上缘结膜面出针;于结膜面原出针点进针,斜向内由皮面B点出针;同法依次贯穿C、D、E点;再由内向外依次贯穿E、D、C、B、A点;将两线端穿过3/8弧圆针,由A点进针,向外上走行深部并高于重睑线至外眶缘穿出皮面,调整松紧度打结。术后观察手术效果及并发症情况,并于术前及术后6个月行患者满意度评价,包括重睑弧度、宽度、流畅度、对称性4项,满分100分,评分越高代表患者越满意。计量资料用±s表示,同一例患者手术前后满意度的比较采用配对样本t检验,P<0.05表示差异有统计学意义。结果共纳入82例患者160只眼,女性75例,男性7例;年龄18~32岁,平均25.4岁;双侧单睑78例,单侧单睑4例。术后早期8例患者眼睑局部青紫、轻微肿胀,给予常规冷敷处理后好转;2例眼球伴有异物感,应用左氧氟沙星滴眼液1周后症状改善;其余患者重睑形态良好,眼睑无明显肿胀及异物感。共60例随访满6个月,患者重睑形态自然、美观,睁眼时重睑线流畅,闭眼无明显手术痕迹,仅1例患者重睑线变浅,予再次埋线修复后效果满意。所有患者均无线结外露、皮下结节等并发症发生。术前患者满意度评分为(58.15±5.07)分,术后6个月为(98.68±1.69)分,差异有统计学意义(t=-70.33,P<0.001)。结论双W形皮肤-结膜贯穿连续埋线法重睑术具有微创、简易、直视操作等优点,术后重睑形态自然,患者满意度高。Objective To explore the effect of double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva.Methods The data of patients received double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva in Department of Medical Aesthetic Surgery,People’s Hospital of Rizhao,and Department of Plastic Surgery,Yimeitiancheng’s Cosmetic and Plastic Hospital of Rizhao from January 2021 to June 2022 were retrospectively analyzed.Before the operation,the double eyelid line was designed and 5 points were evenly marked along the line as A,B,C,D and E(from the lateral to the internal).During the operation,10 ml needle was used to puncture the 5 points marked on the double eyelid line.Starting from the outermost point A,the needle was inserted obliquely inward on the skin surface,and then the upper eyelid was turned over,and the stitches was stabed-out from the conjunctival surface of the upper margin of tarsus.The stitches was inserted again from the original point pierced on the conjunctival surface,and the stitches was stabed-out diagonally inward through the skin surface at the point B.The same method was used to penetrate points C,D and E successively.Then E,D,C,B and A points were penetrated in turn from the inside to the outside.The two suture ends were passed through the 3/8 arc round stitches,which was inserted from the point A and stabed-out skin surface of the outer orbital margin above the double eyelid line through the deep.The tightness was adjusted and tied the knotted.After the surgery,the surgical results and complications were observed,and patients’satisfaction was evaluated before and 6 months after the surgery,which included four factors:eyelid curvature,width,smoothness,and symmetry,with a maximum score of 100.Higher scores indicated greater patients’satisfaction.Measurement data were expressed as Mean±SD,and paired sample t-test was used to compare the satisfaction of the same patient before and after surg

关 键 词：眼睑成形术 重睑 埋线法 双W形 

分 类 号：R779.6[医药卫生—眼科]