A字法内眦赘皮过度矫正修复术的效果  

Clinical effects of A-plasty repair surgery for overcorrection of epicanthus

作　　者：隋长清 余海洋 李丹 杨超 Sui Changqing;Yu Haiyang;Li Dan;Yang Chao(Department of Comestic Surgery,Shanghai Biotree Comestic Hospital,Shanghai 200335,China;Department of Orthopedic Surgery,PLA Navy Medical Center,Shanghai 200052,China)

机构地区：[1]上海生命树医疗美容医院美容外科,上海200335 [2]解放军海军特色医学中心整形外科,上海200052

出　　处：《中华医学美学美容杂志》2024年第2期140-143,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨应用A字法行内眦赘皮过度矫正修复术的临床效果。方法2019年12月至2021年5月,上海生命树医疗美容门诊部美容外科对内眦赘皮过度矫正患者100例进行A字法修复术治疗,男2例、女98例;年龄19~43(28.0±5.7)岁。A字法内眦赘皮过度矫正修复术通过手术祛除内眦部三角形皮瓣,内眦部皮下及眼轮匝肌深面进行广泛的分离松解。眼轮匝肌瓣折叠缝合覆盖内眦韧带表面,缝合泪阜段皮肤及切口鼻侧上下缘皮肤。术后随访6~22个月,评估手术效果及患者满意度。结果100例患者术前存在的泪阜过度暴露、双侧内眼角角度过尖、不对称、内眦部陈旧瘢痕等问题得到了改善。术前内眦角间距为(33.64±3.51)mm,术后为(35.92±3.12)mm,差异有统计学意义(P<0.05)。术前左侧眼裂长度为[(28.92±1.07)mm,右侧为(28.94±1.04)mm],术后分别为(27.78±1.03)、(27.79±1.02)mm,差异均有统计学意义(均P<0.05)。患者非常满意69例,占69%;满意19例,占19%;较不满意7例,占7%;不满意5例,占5%。5例不满意患者中3例是因泪阜暴露矫正不足,2例因内眦角度形态不对称,重新手术获得满意效果。结论A字法内眦赘皮过度矫正修复祛除部分上睑瘢痕,恢复眼轮匝肌结构的完整性,重建内眦赘皮,调整眼角角度和形态等效果显著,值得临床应用。Objective To investigate the surgical method and clinical efficacy of A-plasty for the repair of the overcorrected epicanthus.Methods From December 2019 to May 2021,100 patients with epicanthus overcorrection underwent A-plasty repair surgery in the Department of Comestic Surgery of Shanghai Biotree Comestic Medical Hospital,including 2 males and 98 females,aged 19-43(28.0±5.7)years.In the A-plasty repair surgery,the triangular flap of the inner canthus was removed,and the subcutaneous surface of the inner canthus and the deep surface of the orbicularis oculi muscle were extensively separated and loosened.The flap of orbicularis oculi muscle was folded and sutured to cover the ligament surface of the inner canthus,the skin of the lacrimal pars and the skin of the upper and lower nasal side of the incision.Postoperative follow-up was conducted for 6-22 months to evaluate the operative effect and patient satisfaction.Results In 100 patients,problems such as overexposure of lacrimal mound,pointed angle of bilateral inner canthus,asymmetry of bilateral inner canthus and old scar of inner canthus were improved.The angle distance between inner canthus was(33.64±3.51)mm before operation and(35.92±3.12)mm after operation,the difference was statistically significant(P<0.05).The left fissure length before surgery was(28.92±1.07)mm,the right one was(28.94±1.04)mm,and the postoperative fissure length was(27.78±1.03)mm and(27.79±1.02)mm,respectively,with statistical significance.69 cases(69%)were very satisfied.19 cases(19%)were satisfied.7 cases(7%)were less satisfied.5 cases(5%)were dissatisfied.Among the 5 cases of dissatisfaction,3 cases were due to insufficient correction of lacrimal mound exposure and 2 cases were due to angular asymmetry of inner canthus.These 5 patients were reoperated and finally obtained satisfactory results.Conclusions The A-plasty repair surgery has a significant effect of removing some upper eyelid scars,restoring the integrity of orbicularis oculi muscle structure,rebuilding epicanthus,an

关 键 词：修复外科手术 内眦赘皮 内眦赘皮矫正术后 A字法 修复手术 

分 类 号：R779.6[医药卫生—眼科]