皮肤-眼轮匝肌瓣切除术对老年性下睑内翻的疗效观察  

Effect of skin-orbicularis oculi muscle flap resection in the treatment of involutional lower eyelid entropion

作　　者：陆可卫[1] 刘路宏[1] 闫玉梅[1] 陈琦[2] 黄朝晖[1] LU Kewei;LIU Luhong;YAN Yumei;CHEN Qi;HUANG Zhaohui(Department of Ophthalmology,the People's Hospital of Guangxi Zhuang Autonomous Region&Guangxi Key Laboratory of Eye Health&Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Arificial Intelligence Screening Technology&Institute of Ophthalmic Diseases,Guangxi Academy of Medical Sciences,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院眼科,广西眼健康重点实验室,广西壮族自治区卫生健康委员会眼部与相关全身疾病人工智能筛查技术重点实验室,广西医学科学院眼科疾病医学研究所,广西南宁530021 [2]广西壮族自治区人民医院视光科,广西眼健康重点实验室,广西壮族自治区卫生健康委员会眼部与相关全身疾病人工智能筛查技术重点实验室,广西医学科学院眼科疾病医学研究所,广西南宁530021

出　　处：《中国美容整形外科杂志》2024年第5期263-266,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：广西眼科疾病临床医学研究中心(桂科AD19245193);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180747)。

摘　　要：目的 探讨皮肤-眼轮匝肌瓣切除术对老年性下睑内翻的疗效。方法 选取自2017年3月至2022年6月,广西壮族自治区人民医院眼科收治的118例老年性下睑内翻患者作为研究对象,按照随机数表法分为观察组(59例)和对照组(59例),对照组采用肌皮瓣+外侧睑板楔形切除术治疗,观察组采用皮肤-眼轮匝肌瓣切除术治疗,比较两组手术效果(睑裂宽度、睫毛朝向和泪阜显露率)、眼睑功能[泪膜破裂时间(breaking-up time, BUT)、角膜荧光素染色(fluorescent staining,FL)],眼部症状评分[采用眼表疾病指数(ocular surface disease index, OSDI)],眼周皮肤瘢痕和术后并发症。结果 术后3个月,观察组睑裂宽度、睫毛朝向和泪阜显露率高于对照组(t=2.522;t=6.125;t=5.851,P<0.05);观察组BUT水平高于对照组,FL水平低于对照组(t=2.664;t=7.046,P<0.05);观察组畏光、流泪、刺激感、异物感评分均低于对照组(t=3.473;t=2.607;t=3.763;t=3.788,P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 皮肤-眼轮匝肌瓣切除术对老年性下睑内翻的手术效果较好,可有效提高眼睑功能,减轻眼部症状。Objective To explore the effect of skin-orbicularis oculi muscle flap resection in the treatment of involutional lower eyelid entropion. Methods A total of 118 case of patients with senile lower eyelid entropion were selected as the observation subjects between March 2017 and June 2022. According to the random number table method, they were divided into 59 cases in the observation group and 59 cases in the control group. The control group was treated with skin muscle flap combined with lateral tarsal plate wedge resection,and the observation group was treated with skin-orbicularis oculi muscle flap resection. The surgical outcome(eyelid width, eyelash orientation, and caruncula lacrimalis exposure), eyelid function [tear film breaking-up time(BUT), corneal fluorescein staining(FL)], ocular symptom scores [using the ocular surface disease index(OSDI)], and postoperative complications were compared between two groups. Results At 3 months after surgery, the eyelid width, eyelash orientation and caruncula lacrimalis exposure in observation group were higher than those in control group(t=2.522;t=6.125;t=5.851, P<0.05). At 3 months after surgery, the BUT level was higher in the observation group than in the control group and the FL level was lower than in the control group(t=2.664;t=7.046, P<0.05). At 3 months after surgery, the scores of photophobia, lacrimation, irritation and foreign body sensation were lower in the observation group than in the control group(t=3.473;t=2.607;t=3.763;t=3.788, P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Skin-orbicularis oculi muscle flap resection has a good effective on involutional lower eyelid entropion, which can effectively improve eyelid function and reduce ocular symptoms.

关 键 词：下睑内翻 皮肤-眼轮匝肌瓣切除术 眼睑功能 老年性下睑内翻 

分 类 号：R779.6[医药卫生—眼科]