重睑成形联合泪腺复位术治疗眼睑皮肤松弛症伴泪腺脱垂的临床与美学效果  

Clinical and Aesthetic Effects of Double Blepharoplasty Combined with Lacrimal Gland Reduction in the Treatment of Eyelid Cutaneous Laxity with Lacrimal Gland Prolapse

作　　者：徐桐 杨栋民 齐贺斌 XU Tong;YANG Dongmin;QI Hebin(Department of Laboratory Medicine,Qinhuangdao Workers'Hospital,Qinhuangdao 066000,Hebei,China;Department of Plastic and Reconstructive Surgery,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市工人医院检验科,河北秦皇岛066000 [2]秦皇岛市第一医院整形美容外科,河北秦皇岛066000

出　　处：《中国美容医学》2024年第6期38-41,共4页Chinese Journal of Aesthetic Medicine

基　　金：秦皇岛市科学技术研究与计划发展项目(编号:202101A194)。

摘　　要：目的:探究重睑成形联合泪腺复位术治疗眼睑皮肤松弛症伴泪腺脱垂的美学效果及对泪液循环的影响。方法:选取2019年4月-2022年6月笔者医院收治的103例眼睑皮肤松弛症伴泪腺脱垂患者,行重睑成形联合泪腺复位术,随访时间为术前、术后1周和术后5个月。记录患者住院时间与眼部外观恢复正常时间,对比手术前后美学效果、瘢痕评分、泪液循环[泪液分泌量(Schirmer I test,SIt)、泪膜破裂时间(Tear film break up time,BUT)],观察术后有无不良反应情况。结果:所有患者均顺利完成手术,术后眼眶CT检查双眼上睑外侧平整,泪腺复位良好,患者平均住院时间为(3.29±0.37)d,平均眼部外观恢复正常时间为(8.17±2.15)d。与治疗前相比,患者治疗后角膜内侧睑缘与重睑褶皱距离(Medial corneal margin-fold distance,MCMFD)、瞳孔中点睑缘与重睑褶皱距离(Middle pupil margin-fold distance,MPMFD)及外眦处睑缘与重睑褶皱距离(Lateral canthus margin-fold distance,LCMFD)均明显缩短,皱纹情况评分明显降低,差异有统计学意义(P<0.05);术后5个月,患者温哥华瘢痕量表(Vancouver scar scale,VSS)中色泽、血管分布、厚度及柔软度评分均较术后1周明显降低,差异有统计学意义(P<0.05);与治疗前相比,患者治疗后SIt减少,BUT缩短,差异有统计学意义(P<0.05);术后,有3例患者手术部位轻度水肿、2例患者眼部干燥,不良反应总发生率为4.85%。结论:重睑成形联合泪腺复位术治疗眼睑皮肤松弛症伴泪腺脱垂效果确切,可明显提升美学效果,改善泪液循环,值得临床推广。Objective To investigate the cosmetic results of double-eyelid plasty combined with lacrimal gland reduction in the treatment of blepharochalasis complicated with dislocation of lacrimal gland,and the impact on tear circulation.Methods Totally,103 patients with blepharochalasis complicated with dislocation of lacrimal gland were admitted to the author's hospital from April 2019 to June 2022.They were treated with double-eyelid plasty combined with lacrimal gland reduction.The follow-up time was preoperative,one week andfive months postoperatively.The length of hospital stay,recovery time of eye appearance,cosmetic results before and after surgery,scar score,tear circulation[Schirmer I test(SIt)and tearfilm break up time(BUT)],and adverse reactions were recored.Results All patients successfully completed the surgery.Postoperative orbital CT examination showed that the outer side of the upper eyelid wasflat and the lacrimal gland was well repositioned.The hospital stay of the patients was(3.29±0.37)d,and eye appearance recovery time of the patients was(8.17±2.15)d.Compared with before treatment,the medial corneal margin-fold distance(MCMFD),middle pupil margin-fold distance(MPMFD),and lateral canthus margin-fold distance(LCMFD)at the outer canthus were significantly shortened after treatment,and the wrinkle score was significantly reduced,with statistically significant differences(P<0.05).At 5 months after surgery,the color,vascular distribution,thickness,and softness scores on the Vancouver Scar Scale(VSS)were significantly reduced compared to 1 week after surgery,with statistically significant differences(P<0.05).Compared with before treatment,the patient's SIT decreased and BUT shortened after treatment,with a statistically significant difference(P<0.05).Compared with before treatment,the patient's SIt decreased and BUT shortened after treatment,with a statistically significant difference(P<0.05).After surgery,there were 3 patients with mild edema at the surgical site and 2 patients with dry eyes.The

关 键 词：眼睑皮肤松弛症 泪腺脱垂 重睑成形 泪腺复位术 美学效果 泪液循环 

分 类 号：R779.6[医药卫生—眼科]