埋没导引上睑提肌缩短术与单纯上睑提肌缩短术治疗上睑下垂的效果比较  

Comparison of Effect of Embedding Guided Levator Palpebrae Superioris Shortening and Simple Levator Palpebrae Superioris Shortening in the Treatment of Ptosis

作　　者：崔迎欣 常晓雪 吴霞 王坤 张爱雪 孟克青 CUI Yingxin;CHANG Xiaoxue;WU Xia;WANG Kun;ZHANG Aixue;MENG Keqing(Department of Ophthalmology,Beijing Nuclear Industry Hospital,Beijing 100032,China;Department of Ophthalmology,Capital Medical University Miyun Teaching Hospital,Beijing 101500,China;Department of Cataract,Hebei Eye Hospital&Hebei Key Laboratory of Ophthalmology&Hebei eye disease clinical medical research center,Xingtai 054001,Hebei,China)

机构地区：[1]北京核工业医院眼科,北京102413 [2]首都医科大学密云教学医院眼科,北京101500 [3]河北省眼科医院&河北省眼科学重点实验室&河北省眼部疾病临床医学研究中心白内障科,河北邢台054001

出　　处：《中国美容医学》2025年第2期84-88,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨埋没导引上睑提肌缩短术与单纯上睑提肌缩短术两种术式分别对于治疗上睑下垂的效果。方法:回顾性分析2020年3月-2023年3月期间笔者医院就诊的上睑下垂患者临床资料,将接受埋没导引上睑提肌缩短术的40例患者(47眼)纳入观察组,将接受单纯上睑提肌缩短术的40例患者(46眼)纳入对照组。比较两组患者的手术情况(手术时间、切口大小、术中出血量)和术后并发症(暴露性角膜炎、倒睫、结膜脱垂、上睑迟滞、感染),并记录手术前、术后3个月时和术后12个月时的眼睑生理功能[上睑缘至角膜中央反光的距离(Upper lid margin to corneal reflex distance 1,MRD1)、双眼对称性、上睑弧度变化]和美学效果[面部整体美容效果改善评分(The global aesthetic improvement scale,GAIS)、眼睑美学效果、瘢痕美容评估及评级量表(Scar cosmesis assessment and rating,SCAR)]。结果:两组完成手术的时间、切口大小和术中失血量差异无统计学意义(P>0.05);观察组的并发症总发生率显著低于对照组(P<0.05)。术后3个月时,两组双眼对称性均优于术前(P<0.05),但组间比较差异无统计学意义(P>0.05),而术后12个月时,两组双眼对称性均优于术前(P<0.05),观察组的双眼对称性显著优于对照组(P<0.05);术后3个月和12个月时,两组患者的MRD1、上睑弧度变化、GAIS和眼睑美学效果均较术前显著提高,且观察组高于对照组(均P<0.05);两组的SCAR较术前显著下降,且观察组显著低于对照组(均P<0.05)。结论:采用埋没导引上睑提肌缩短术治疗上睑下垂能够明显改善眼部的外观和生理功能,避免瘢痕的出现,具有较好的美学效果。Objective To explore the effect of two treatment methods of embedding guided levator palpebrae superioris shortening and simple levator palpebrae superioris shortening in the treatment of ptosis.Methods Clinical data of patients with ptosis treated in the author's hospital from March 2020 to March 2023 were retrospectively analyzed.40 patients(47 affected eyes)who received embedding guided levator palpebrae superioris shortening and simple levator palpebrae superioris shortening were included in observation group,and 40 patients(46 affected eyes)who underwent simple levator palpebrae superioris shortening were enrolled as control group.The surgical conditions(surgical time,incision size,intraoperative blood loss)and postoperative complications(exposure keratitis,trichiasis,conjunctival prolapse,upper eyelid hysteresis,infection)were compared between the two groups.The eyelid physiological function[marginal reflex distance(MRD1),binocular symmetry,upper eyelid curvature change]and aesthetic effect[Global Aesthetic Improvement Scale(GAIS),eyelid aesthetic effect,Scar Cosmesis Assessment and Rating(SCAR)]were recorded before surgery and at 3 months and 12 months after surgery.Results There were no significant differences in surgical time,incision size and intraoperative blood loss between the two groups(P>0.05).The total incidence rate of complications in observation group was significantly lower compared with that in control group(P<0.05).At 3 months after surgery,the symmetry of both eyes was better than that before surgery(P<0.05),but there was no significant difference between the two groups(P>0.05).At 12 months after surgery,the symmetry of both eyes was better than that before surgery(P<0.05),and the symmetry of both eyes in the observation group was significantly better than that in the control group(P<0.05).At 3 months and 12 months after surgery,the MRD1,upper eyelid curvature change,GAIS and eyelid aesthetic effect in the two groups were significantly improved compared with those before surgery,and the abo

关 键 词：埋没导引 上睑提肌缩短术 上睑下垂 美学效果 眼睑功能 

分 类 号：R779.6[医药卫生—眼科]