眉上与眉下联合切口上睑提升术改善上睑皮肤松弛的效果  

Effect of upper eyelid lifting with combined incision above and below eyebrow in treatment of upper eyelid skin laxity

作　　者：张芳[1,2] 申丽 李广帅 Zhang Fang;Shen Li;Li Guangshuai(Department of Plastic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Aesthetic Surgery,Zhengzhou Mylike Medical Cosmetic Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院整形外科,郑州450000 [2]郑州美莱医疗美容医院美容外科,郑州450000

出　　处：《中华医学美学美容杂志》2024年第2期131-135,共5页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：河南省高等学校重点科研项目计划(20A320033);河南省2022年科技发展计划(222102310188)。

摘　　要：目的探讨上睑皮肤松弛患者行眉上与眉下联合切口上睑提升术对治疗效果的影响。方法2020年6月至2021年6月,郑州美莱医疗美容医院美容外科收集上睑皮肤松弛患者90例,男21例、女69例,年龄45~70(55.3±6.3)岁。根据手术方式分为眉上切口组(28例)、眉下切口组(22例)、联合切口组(40例)。比较3组眉峰点垂直线上睑缘至眉毛距离(distance between upper eyelid and eyebrows,DEE)、睑裂高度经瞳孔上下睑缘间距离(palpebral fissure height,HPF)、眉毛至发际线距离(distance between eyebrows and hairline,DEH)、Lemperle评分、满意度、视觉模拟评分(visual analogue scale,VAS)、术后并发症。结果联合切口组术后恢复时间(39.38±6.53)d、消肿时间(9.18±2.07)d均大于眉上切口组[(30.14±5.37)、(7.43±2.85)d]、眉下切口组[(31.64±5.10)、(7.59±2.48)d](t=6.16、2.93、4.81、2.68,均P<0.05)。治疗6个月后,3组HPF均上升,DEH均下降,且联合切口组变化程度更明显(t=2.86、6.14、2.86、5.86,均P<0.05)。眉上切口组患者Lemperle评分为(1.50±0.51)分,眉下切口组为(1.50±0.51)分,联合切口组为(1.05±0.22)分;联合切口组Lemperle评分小于眉上切口组、眉下切口组(P<0.05)。联合切口组患者与第三方医师VAS评分均大于眉上切口组、眉下切口组(F_(患者)=9.44,F_(第三方)=9.29,均P<0.05)。结论中、重度上睑皮肤松弛患者,眉上与眉下联合切口上睑提升术更能改善松弛状态,减少皱纹,提升手术效果,安全性较好,值得临床应用。Objective To explore the effect of upper eyelid lifting with combined supraeyebrow and infraeyebrow incision on the treatment of patients with upper eyelid skin laxity.Methods From June 2020 to June 2021,the Plastic Surgery Department of Zhengzhou Mylike Cosmetic Hospital collected 90 patients with upper eyelid skin laxation,including 21 males and 69 females,aged 45-70 years,with an average age of(55.3±6.3)years.They were divided into suprabellar incision group(28 cases),suprabellar incision group(22 cases)and combined incision group(40 cases).The distance from upper eyelid margin to eyebrow(DEE),the distance between upper eyelid margin and lower eyelid margin via pupil(HPF),the distance from eyebrow to hairline(DEH),Lemperle score,satisfaction,visual analogue score(VAS)and postoperative complications were compared among the 3 groups.Results The postoperative recovery time(39.38±6.53)d and detumescence time(9.18±2.07)d in the combined incision group were higher than those in the suprabucicular incision group[(30.14±5.37),(7.43±2.85)d]and the suprabucicular incision group[(31.64±5.10),(7.59±2.48)d](t=6.16,2.93,4.81,2.68,P<0.05).After 6 months of treatment,HPF increased and DEH decreased in all the 3 groups,and the degree of change was more significant in the combined incision group(t=2.86,6.14,2.86,5.86,P<0.05).Lemperle score was(1.50±0.51)in suprabellar incision group,(1.50±0.51)in suprabellar incision group,and(1.05±0.22)in combined incision group(P<0.05).The Lemperle score of the combined incision group was lower than that of the suprabucicular incision group and subeyebrow incision group,and the VAS score of the combined incision group and the third party was higher than that of the suprabucicular incision group and subeyebrow incision group(F_(patient)=9.44,F_(third party)=9.29,P<0.05).Conclusions For patients with moderate and severe upper eyelid skin laxity,the upper eyelid lifting surgery with combined incision above and below the eyebrow can better improve the laxity,reduce wrinkles and improve

关 键 词：眼睑 眉上 眉下 联合切口 上睑提升术 上睑皮肤松弛 

分 类 号：R779.6[医药卫生—眼科]