上提眼轮匝肌下脂肪与眶隔和眶隔脂肪吻合固定法矫正泪沟型眼袋  

Anastomosis fixation method of lifting the suborbicularis oculi fat and fixing with the orbital septum and fat to correct eyelid bags with tear trough deformity

作　　者：李高峰[1] 张万红 陈倩 丁卫[1] 张博[1] 方曼 罗由琦 刘小加[1] Li Gaofeng;Zhang Wanhong;Chen Qian;Ding Wei;Zhang Bo;Fang Man;Luo Youqi;Liu Xiaojia(Department of Plastic Surgery and Cosmetic Laser Center,Hunan Provincial People's Hospital(the First Affiliated Hospital of Hunan Normal University),Changsha 410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)整形激光美容科,长沙410005

出　　处：《中华整形外科杂志》2024年第7期709-715,共7页Chinese Journal of Plastic Surgery

摘　　要：目的探讨采用上提眼轮匝肌下脂肪(SOOF)与眶隔和眶隔脂肪吻合固定的方法矫正泪沟型眼袋的临床效果。方法回顾性分析2019年1月至2021年1月,湖南省人民医院(湖南师范大学附属第一医院)收治的经下睑缘下皮肤入路矫正泪沟型眼袋的患者临床资料。术中将SOOF上提,与下推的眶隔和眶隔脂肪整体吻合性缝合固定,进行眼袋矫正、泪沟填充及中面部提升。术后观察切口愈合和并发症发生情况,对眼袋、泪沟和中面部下垂的矫正情况进行随访;通过Adobe Photoshop CS6软件测量术前和末次随访时鼻唇颊脂肪凸起点至下睑缘的垂直距离,评价中面部下垂矫正效果,数据以±s表示,术前后比较采用配对t检验,P<0.05为差异有统计学意义;由患者本人和1名护士对手术效果进行满意度评价,两者须达成一致意见,分为满意、基本满意、不满意3个等级。结果共纳入132例患者(264只眼),其中男23例,女109例;年龄(50.3±6.0)岁;Hirmand泪沟分型:Ⅱ型178只眼,Ⅲ型86只眼。术后伤口愈合良好,未出现血肿、感染、复视、角膜异物感及外眼角拉紧不适感等并发症。术后随访6~12个月,264只眼中252只眼袋消失,12只眼袋减轻;86只Ⅲ型泪沟眼中有10只改善为Ⅰ型,其余76只Ⅲ型和178只Ⅱ型术后泪沟均消失;264侧中面部下垂情况均有改善,术后鼻唇颊脂肪凸起点到下睑缘的垂直距离较术前明显缩短[(29.23±1.58)mm vs.(34.08±3.23)mm(t=22.88,P<0.001)]。满意度评价结果:118例满意(满意率为89.4%),14例基本满意。结论上提SOOF与眶隔和眶隔脂肪吻合固定法矫正泪沟型眼袋,不但能有效去除眼袋、平复泪沟,而且能提升中面部,达到年轻化的效果,患者满意率较高。Objective To investigate the clinical effectiveness of anastomosis fixation method of lifting the suborbicularis oculi fat(SOOF)and fixing with the orbital septum and fat to correct eyelid bags with tear trough deformity.Methods A retrospective analysis was conducted on patients treated at Hunan Provincial People’s Hospital(the First Affiliated Hospital of Hunan Normal University)from January 2019 to January 2021.The patients underwent lower eyelid blepharoplasty via a sub-lower eyelid skin approach.During the surgery,the SOOF was lifted and fixed with the orbital septum and fat,correcting the eye bags,filling the tear troughs,and lifting the midface.Postoperative observations included incision healing and complications.The correction of eye bags,tear troughs,and midface sagging was followed up.Adobe Photoshop CS6 software was used to measure the vertical distance from the nasolabial and buccal fat prominent point to the lower eyelid margin before surgery and at the last follow-up to evaluate the correction of midface sagging.Data were expressed as Mean±SD,and pre-and post-operative comparisons were analyzed using paired t-test,with P<0.05 indicating statistical significance.Patients’and nurses’satisfaction evaluations of surgical outcomes were classified into three levels:satisfied,basically satisfied,and dissatisfied,requiring consensus between the two evaluators.ResultsA total of 132 patients(264 eyes)were included,consisting of 23 males and 109 females,with an average age of(50.3±6.0)years.Hirmand tear trough classification included 178 typeⅡeyes and 86 typeⅢeyes.Postoperative wound healing was well,with no hematoma,infection,diplopia,corneal foreign body sensation,and discomfort from external eye corner tightness.Follow-up ranged from 6-12 months,with 252 out of 264 eye bags disappeared and 12 eye bags reduced.Among the 86 typeⅢtear trough eyes,10 improved to typeⅠ,while the remaining 76 typeⅢand 178 typeⅡtear troughs disappeared postoperatively.All 264 midface sagging cases showed improv

关 键 词：眼睑成形术 眼袋 泪沟 下睑成形术 眼轮匝肌下脂肪 中面部年轻化 

分 类 号：R62[医药卫生—整形外科] R779.6[医药卫生—外科学]