可调式硅胶带悬吊术治疗重症肌无力型上睑下垂的效果  

Clinical effects of adjustable silicone strap suspension on myasthenia gravis ptosis

作　　者：赵敏[1] 焦峰[1] 段敏[1] 杨帆[1] 凃惠芳 Zhao Min;Jiao Feng;Duan Min;Yang Fan;Tu Huifang(Department of Ophthalmology,Aier Eye Hospital Affiliated to Wuhan University,Wuhan 430061,China)

机构地区：[1]武汉大学附属爱尔眼科医院眼整形科,武汉430061

出　　处：《中华医学美学美容杂志》2024年第4期350-353,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的观察可调式硅胶带悬吊术对重症肌无力型上睑下垂患者的矫正效果。方法回顾性纳入2019年1月至2020年1月武汉大学附属爱尔眼科医院眼整形科重症肌无力型上睑下垂患者60例, 男35例、女25例, 年龄25~58岁, 平均35.63岁;分为对照组与观察组各30例。对照组用轮匝肌转位术治疗, 观察组用可调式硅胶带悬吊术治疗, 比较两组上睑下垂的矫正效果、满意度、恢复状况、眼表功能指标、复发率及并发症发生情况。结果观察组手术优良率93.33%(28/30)高于对照组63.33%(19/30)(χ^(2)=6.29, P<0.05)。观察组患者满意度100%(30/30)高于对照组76.67%(23/30)(χ^(2)=5.82, P<0.05)。观察组与对照组术前角膜曲率与荧光素染色均显著低于术后状态(t=6.17、21.48 , 均P<0.05)。观察组术后3个月的角膜曲率与荧光素染色评分均高于对照组术后3个月状态(t=3.00、9.06, 均P<0.05)。两组眼睑闭合不全、上睑内翻倒睫、上睑弧度不自然等并发症发生率差异无统计学意义(χ^(2)=0.19, P>0.05)。术后3个月随访, 观察组复发率为0, 低于对照组(χ^(2)=4.63, P<0.05)。结论可调式硅胶带悬吊术适用于治疗重症肌无力型上睑下垂患者, 可显著提高手术成功率及美学效果, 术后并发症发生率、复发率低。Objective To observe the clinical effect of adjustable silicone strap suspension in the treatment of myasthenia gravis ptosis.Methods From January 2019 to January 2020,60 patients with myasthenia gravis ptosis(35 males,25 females,age distribution from 25 to 58 years,with average of 35.63 years)were collected from the Department of Ophthalmoplasty of Aier Eye Hospital affiliated to Wuhan University.They were divided into control group and observation group,with 30 cases in each group.The observation group was treated with adjustable silicone band suspension,and the correction effect,satisfaction,recovery status,ocular surface function index,recurrence rate and complications of the two groups were compared.Results The excellent rate of operation in the observation group was 93.33%(28/30),which was significantly higher than 63.33%(19/30)in the control group(χ^(2)=6.29,P<0.05),and the satisfaction of patients in the observation group was 100%(30/30),which was significantly higher than 76.67%(23/30)in the control group(χ^(2)=5.82,P<0.05).The preoperative corneal curvature and fluorescein staining in the observation group and the control group were significantly lower than those in the postoperative state(t=6.17,21.48,P<0.05).The corneal curvature and fluorescein staining score of the observation group were significantly higher than those of the control group at 3 months after surgery(t=3.00,9.06,P<0.05).There was no significant difference between the two groups in the incidence of complications such as eyelid imclosure,upper eyelid inversion and unnatural upper eyelid curvature(χ^(2)=0.19,P>0.05).Follow up at 3 months after surgery,the recurrence rate in the observation group was lower than that in the control group(χ^(2)=4.63,P<0.05).Conclusions Surgery is an option for patients with myasthenia gravis ptosis who are not responding well to medical treatment and whose condition is stable.Adjustable silicone strap suspension for the treatment of myasthenia gravis ptosis can significantly improve the surgical success

关 键 词：重症肌无力 上睑下垂 可调式 硅胶带悬吊术 美学效果 

分 类 号：R779.6[医药卫生—眼科]