不同矫正手术治疗老年性下睑内翻合并倒睫的美学效果及对睑板功能的影响  

Cosmetic Outcomes of Different Corrective Surgeries in the Treatment of Senile Lower Lid Entropion Complicated with Trichiasis and the Impact on Tarsus Function

作　　者：郑中文 唐棣 桂思 ZHENG Zhongwen;TANG Di;GUI Si(Department of Burn and Plastic Surgery,General Hospital of the Central Warzone of the Central Theater Command,Wuhan 430000,Hubei,China)

机构地区：[1]中国人民解放军中部战区总医院烧伤整形科,湖北武汉430000

出　　处：《中国美容医学》2024年第7期78-81,共4页Chinese Journal of Aesthetic Medicine

基　　金：湖北省自然科学基金(编号:2021CFB164)。

摘　　要：目的:探讨不同矫正手术治疗老年性下睑内翻合并倒睫的美学效果及对睑板功能的影响。方法:选取2020年9月-2023年4月笔者医院收治的老年性下睑内翻合并倒睫患者103例,使用随机数字表法分为研究组(n=51)和对照组(n=52)。对照组患者接受皮肌瓣联合外侧睑板楔形切除术治疗,观察组接受单纯皮肤-眼轮匝肌瓣切除术治疗。比较两组术后美学效果满意度、手术前后眼睑功能、手术相关指标、治疗效果相关指标以及术后并发症发生情况。结果;观察组术后美学效果总满意度为94.12%,高于对照组的80.77%(P<0.05);观察组睑缘评分、睑板腺挤压试验评分低于对照组,睑板腺脂质分泌情况评分高于对照组(P<0.05);两组泪阜显露率、睑裂宽度以及睫毛朝向均高于术前,且观察组高于对照组(P<0.05);两组泪膜破裂时间(Break-up time,BUT)高于术前,泪腺分泌试验(Schirmer’s test,SIT)、角膜荧光素染色试验(Corneal fluorescein staining,CSF)低于术前,且观察组BUT高于对照组,SIT、CSF低于对照组(P<0.05);观察组术后并发症总发生率为7.84%,与对照组的13.46%相比较,差异无统计学意义(P>0.05)。结论:单纯皮肤-眼轮匝肌瓣切除术相较于皮肌瓣联合外侧睑板楔形切除术更有利于提高老年性下睑内翻合并倒睫患者整体美观性,改善睑板功能等效果。Objective To investigate the cosmetic outcomes of different corrective surgeries in the treatment of senile lower lid entropion complicated with trichiasis,and the impact on tarsus function.Methods A total of 103 patients with senile lower lid entropion and trichiasis who were admitted to the hospital from September 2020 to April 2023 were selected,and divided into the study group(n=51)and the control group(n=52)by random number table method.Patients in the control group were treated with wedge resection of musculocutaneous flap and lateral tarsus,while patients in the observation group were treated with simple skin-orbicularis oculi muscle flap resection.The two groups were compared in terms of satisfaction with postoperative cosmetic outcomes,eyelid function before and after operation,operation related indicators,treatment effect related indicators,and the incidence of postoperative complications.Results After operation,the total satisfaction rate of cosmetic outcomes in the observation group(94.12%)was higher than that in the control group(80.77%)(P<0.05).The scores for eyelid margin and testing meibomian gland after extrusion in the observation group were lower than those in the control group,and the meibomian gland lipid secretion score was higher than that in the control group(P<0.05).After operation,the exposure rate of lacrimal caruncle,width of palpebral fissure and eyelash orientation in the two groups were higher than those before operation,and above indicators in the observation group were higher than those in the control group(P<0.05).After operation,break-up time(BUT)in the two groups was longer than that before operation.Schirmer’s test(SIT)and corneal fluorescein staining(CSF)were lower than those before operation.BUT in the observation group was longer than that in the control group.SIT and CSF were lower than those in the control group(P<0.05).The total incidence rates of postoperative complications in the observation group and the control group were 7.84%and 13.46%,without statistically signi

关 键 词：老年性下睑内翻 倒睫 单纯皮肤-眼轮匝肌瓣切除术 皮肌瓣联合外侧睑板楔形切除术 美学效果 睑板功能 

分 类 号：R779.6[医药卫生—眼科]