联合筋膜鞘悬吊术+提上睑肌缩短术治疗bell征阴性重度上睑下垂的临床观察  

Clinical study of combined fascial sheath suspension and levator muscle shortening for bell phenomenon-negative severe ptosis

作　　者：耿闫 张丹娜 喻静文 赵文嘉 胡卫群 GENG Yan;ZHANG Danna;YU Jingwen;ZHAO Wenjia;HU Weiqun(Department of Postgraduate Training Base,Xiaogan Central Hospital of Jinzhou Medical University,Xiaogan 432100,China)

机构地区：[1]锦州医科大学孝感市中心医院研究生培养基地,湖北孝感432100 [2]武汉科技大学附属孝感市中心医院眼科,湖北孝感432100

出　　处：《中国美容整形外科杂志》2024年第5期267-270,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：孝感市自然科学计划项目(XGKJ2021010034)。

摘　　要：目的 探讨联合筋膜鞘(conjoint fascial sheath, CFS)悬吊术+提上睑肌(levatormuscle, LM)缩短术治疗bell征阴性重度上睑下垂的临床疗效。方法 回顾性分析自2020年5月至2023年4月,孝感市中心医院眼科行CFS悬吊术联合LM缩短术治疗的10例(17只眼)bell征阴性重度上睑下垂患者的临床资料。CFS悬吊术+LM缩短术:沿设计线切开皮肤后,分离眼轮匝肌等显露睑板。分离提上睑肌,结膜下肿胀麻醉结膜和Müller氏肌,离断提上睑肌和Müller氏肌。沿结膜和Müller氏肌向上分离,找到CFS,将CFS与提上睑肌以5-0丝线固定于睑板中上处。缝合形成重睑。结果 10例患者术后获随访6个月,未见明显回退及不良反应,效果美观,患者满意度较高。结论 采用CFS悬吊术联合LM缩短术矫正bell征阴性的重度上睑下垂,临床效果满意,手术操作安全,可在临床推广应用。Objective To investigate the clinical efficacy of combined with fascial sheath suspension(CFS) and shortening of levator(LM) in the treatment of bell-negative severe ptosis. Methods The clinical data of 10 patients(17 eyes) with severe blepharoptosis were reviewed. After cutting the skin along the design line, the tarsus were exposed by separating the orbicularis oculi muscle. The levator palpebrae superioris was separated, subconjunctival swelling anesthetized conjunctiva and Müller muscle, and the levator palpebrae superioris and Müller muscle were peeled off. CFS was found along the upward separation of conjunctiva and Müller muscle, and the CFS and levator palpebrae were fixed in the middle and upper part of the tarsus with a 5-0 silk thread. A suture of the double eyelids was formed.Results Ten patients were followed up for 6 months, and there was no obvious regression or adverse reaction, with beautiful effect and high patient satisfaction. Conclusion CFS suspension combined with LM shortening was used to correct severe ptosis with satisfactory clinical effect and safe operation, which can be popularized and applied in clinical practice.

关 键 词：联合筋膜鞘悬吊术+提上睑肌缩短术 Bell征阴性 重度上睑下垂 预后 

分 类 号：R779.6[医药卫生—眼科]