改良式中央短切口重睑成形术的临床应用及疗效观察  

Clinical efficacy of modified central short incision double eyelid surgery

作　　者：陈江庭 刘城宏 候典举 Chen Jiangting;Liu Chenghong;Hou Dianju(Department of Plastic Surgery,Chengdu Badachu Medical Aesthetics Hospital,Chengdu 610041,China)

机构地区：[1]成都八大处医疗美容医院整形外科,成都610041

出　　处：《中华整形外科杂志》2024年第7期723-728,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨改良式中央短切口微创重睑成形术的临床效果。方法回顾性分析2018年9月至2023年1月,在成都八大处医疗美容医院行改良式中央短切口重睑成形术的患者资料。通过适当延长传统中央短切口微创重睑成形术的切口,采用保留眼轮匝肌外肌膜的下唇眼轮匝肌浅层离断法,在重睑线上5个标志点处将切口上唇皮肤、上唇眼轮匝肌、下唇眼轮匝肌浅层肌瓣及切口下唇皮肤固定于睑板前筋膜,并同时对上睑眶隔进行重置,间断缝合切口。术后随访观察患者切口愈合及并发症发生情况、重睑形态。术后3个月医生对患者的上睑进行评价打分(总分0~8分,分数越高越满意),并通过门诊问卷或电话随访调查患者满意度。结果纳入94例患者,共147眼,其中31眼伴有上睑下垂;男28例共49眼,女66例共98眼,平均年龄29.7岁(20~41岁)。术后随访6~36个月,平均14个月,切口均一期愈合,未出现感染、瘢痕增生及角膜损伤等并发症;2例出现重睑线变浅,再次以相同手术方法修复,其余患者均恢复良好,睁眼重睑线流畅,形态饱满,未见"肉条"外观,闭眼时切口隐蔽平整,无凹陷、沟痕和台阶样畸形。医生对术后效果评价:141例满意,4例一般,2例不满意。患者满意度:满意及以上142例,一般3例,不满意2例。结论改良式中央短切口微创重睑成形术可充分暴露术野,同时矫正上睑下垂,扩大了微创重睑成形术的适应证范围,方法简便、创伤小、恢复快、瘢痕轻、效果稳定自然,是一种优选的微创重睑手术方法。Objective To investigate the clinical efficacy of the modified central short incision minimally invasive double eyelid surgery.Methods A retrospective analysis was conducted on patients who underwent the modified procedure at Chengdu Badachu Medical Aesthetic Hospital from September 2018 to January 2023.The modification involved extending the traditional central short incision to retain the outer fascial membrane of the orbicularis oculi muscle through shallow layer dissection.At five marked points,the skin and muscle layers of both the upper and lower eyelids were fixed to the pre-tarsal fascia.The upper eyelid orbital septum was also repositioned,postoperative evaluations were performed by doctors,scoring the upper eyelid(0-8 points,with higher scores indicating greater satisfaction)and the incision was intermittently sutured.Patient satisfaction was investigated 3 months after surgery by outpatient questionnaires or telephone follow-up.Results Ninety-four patients(147 eyelids,including 31 with ptosis)were included.There were 28 males(49 eyelids)and 66 females(98 eyelids),aged 20-41 years,with an average age of 29.7 years.Follow-up ranged from 6 to 36 months,averaging 14 months.All incisions healed without infection,scar hyperplasia,or corneal injuries.Two cases required revision surgery for shallow folds.The remaining patients had smooth,full eyelid folds with hidden,flat incisions.Doctors evaluated the postoperative effect:141 cases were satisfied,4 cases were general and 2 cases were dissatisfied.Patient satisfaction:142 cases were satisfied and above,3 cases were generally satisfied and 2 cases were dissatisfied.Conclusion The modified central short incision minimally invasive double eyelid surgery fully exposes the surgical field,corrects ptosis,expands indications and is simple,minimally traumatic,quick to recover from,with minimal scarring and natural result.It is an optimal method for minimally invasive double eyelid surgery.

关 键 词：眼睑成形术 重睑成形术 微创手术 中央短切口 上睑下垂 

分 类 号：R779.6[医药卫生—眼科] R62[医药卫生—临床医学]