改良“Z”瓣成形术在矫正中重度内眦赘皮中的应用  

Application of modified"Z"-plasty in correction of moderate and severe epicanthus

作　　者：周莉娜 付秋悦 陈浩 张天琦 陈威 张杉 陈刚[2] ZHOU Lina;FU Qiuyue;CHEN Hoo;ZHANG Tianqi;CHEN Wei;ZHANG Shan;CHEN Gang(Department of Surgery,Zhangiagang Hospital of Traditional Chinese Me dicine,Zhangiagang 215699,China)

机构地区：[1]张家港市中医医院外科,江苏张家港215699 [2]南京中医药大学附属医院(江苏省中医院)整形外科,江苏南京210029

出　　处：《中国美容整形外科杂志》2025年第1期10-13,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的介绍一种改良“Z”瓣成形术在矫正中重度内眦赘皮中的应用效果。方法选取自2018年1月至2020年12月,于南京中医药大学附属医院(江苏省中医院)整形外科就诊的135例中重度内眦赘皮求美者,行改良“Z”瓣成形术治疗。以求美者术前、术后所测内眦间距(intercanthal distance,ICD)、瞳孔距离(interpupillary distance,IPD)、ICD/IPD比值(ICD比值)为主要观察指标,使用求美者和观察者瘢痕评估量表(patient and observer scar assessmentscale,POSAS)评分评价术后1个月与术后12个月瘢痕情况,并结合求美者自身满意度和并发症情况综合评价手术疗效。结果术前ICD/IPD比值为0.620(0.550~0.670),术后12个月降至0.565(0.490~0.600),差异具有统计学意义(P=0.025)。求美者术后切口均一期愈合,无明显瘢痕,泪阜显露适中,内眦角形态自然,睑裂明显变长增宽。术后12个月,求美者瘢痕评估量表(patient scar assessmentscale,PSAS)评分、观察者瘢痕评估量表(observer scar assessmentscale,OSAS)评分和总体POSAS评分与术后1个月相比,差异均具有统计学意义(P<0.05)。135例求美者术后均无明显并发症。术后12个月时,67例(49.63%)对治疗效果非常满意,35例(25.93%)比较满意,29例(21.48%)一般满意,4例(2.96%)不满意,总满意率为97.04%。结论改良“Z”瓣成形术对于中重度内眦赘皮具有手术设计简单、操作便捷,术后效果明显、持久,瘢痕不明显等优点,值得临床推广应用。Objective To introduce a modified"Z"-plasty in correcting moderate and severe epicanthus,and evaluate its clinical effect.Methods A total of 135 patients with moderate and severe epicanthus were selected and treated with modified"Z"-plasty.The intercanthal distance(ICD),interpupillary distance(IPD),and ICD/IPD ratio(ICD ratio)were measured before and after surgery as the main observation indicators.The POSAS score was used to evaluate the scar status at 1 month and 12 months after surgery,and comprehensively evaluate the surgical efficacy based on the patients'satisfaction and complications.Results The ICD/IPD before surgery was 0.620(range,0.550-0.670)and 0.565(range,0.490-0.600)12 months after surgery(P=0.025).All the incisions were healing by the first intention without obvious scars.The caruncle was moderately exposed,the medial canthus angle was natural,and the palpebral fissure was obviously lengthened and widened.The PSAS score,the OSAS score,and the POSAS score at 12 months after operation were statistically different compared with the scores at 1 month after operation(P<0.05).There were no obvious complications after surgery among 135 patients.Twelve months postoperation,67 patients(49.63%)were satisfied with the outcome,35 patients(25.93%)were moderately satisfied,29 patients(21.48%)were generally satisfied,and only 4 patients(2.96%)expressed dissatisfaction.The overall satisfaction rate was calculated to be97.04%.Conclusion The modified"Z"-plasty has the advantages of simple surgical design,convenient operation,obvious and long-lasting postoperative effects,and inconspicuous scars for moderate and severe epicanthus,and is worthy of clinical promotion.

关 键 词：内眦赘皮 “Z”瓣成形术 内眦赘皮矫正术 ICD比值 POSAS评分 

分 类 号：R779.6[医药卫生—眼科]