改良联合筋膜鞘悬吊及上睑提肌复合体无张力缩短矫正术与额肌瓣悬吊术矫正重度上睑下垂的疗效对比  

Efficacy comparison of modified conjiont fascial sheath suspension combined with tension-free shortening of the levator muscle complex and frontalis muscle flap suspension for severe ptosis correction

作　　者：韩文娟 李毅博 秦文英 曹婷 李燕 HAN Wenjuan;LI Yibo;QIN Wenying;CAO Ting;LI Yan(Department of Plastic Surgery,The First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院整形外科,陕西西安710032

出　　处：《中国美容整形外科杂志》2025年第1期14-17,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的比较改良联合筋膜鞘(conjiont fascial sheath,CFS)悬吊及上睑提肌(levator muscle,LM)复合体无张力缩短矫正术与额肌瓣悬吊术矫正重度上睑下垂的疗效。方法回顾性分析自2021年5月至2024年4月,空军军医大学第一附属医院整形外科手术治疗142例(244只眼)重度上睑下垂患者,按照手术方法分为两组,采用改良CFS悬吊术+LM复合体无张力缩短矫正术的67例(116只眼)患者纳入观察组,采用额肌瓣悬吊术的75例(128只眼)患者纳入对照组。对比两组术后3个月矫正效果、眼睑闭合程度、美容效果、手术并发症、患者满意度。结果患者术后矫正率观察组(93.97%)显著高于对照组(83.59%),P<0.05。患者术后眼睑闭合程度观察组显著优于对照组(P<0.05)。两组眼睑高度、眼睑弧度、重睑情况的美容效果对比,差异无统计学意义(P>0.05)。手术并发症发生率观察组(4.31%)略低于对照组(7.03%),P>0.05。观察组患者满意率(94.03%)显著高于对照组(80.00%),P<0.05。结论改良CFS悬吊术+LM复合体无张力缩短矫正术对重度上睑下垂的矫正率、眼睑闭合程度、患者满意率更优,手术并发症发生率更低,值得临床推广应用。Objective To compare the efficacy of the modified conjiont fascial sheath(CFS)suspension combined with levator muscle(LM)complex tension-free shortening correction and frontalis muscle flap suspension for severe ptosis correction.Methods A total of 142 patients(244 eyes)with severe ptosis received in Department of Plastic Surgery in the First Affiliated Hospital of Air Force Medical University from May 2021 to April 2024 were included.Patients were divided into two groups based on the surgical method:67 cases(116 eyes)who underwent the modified CFS suspension combined with LM complex tension-free shortening correction were included in the observation group,and 75 cases(128 eyes)who underwent frontalis muscle flap suspension were included in the control group.Postoperative correction effects,eyelid closure degree,cosmetic effects,surgical complications,and patient satisfaction were compared at 3 months.Results The observation group exhibited a notably higher correction rate at 93.97%compared to the control group's 83.59%,with statistical significance(P<0.05).The observation group demonstrated a significantly superior postoperative eyelid closure degree than the control group,which was also statistically significant(P<0.05).There was no statistically significant difference in cosmetic effects,including eyelid height,eyelid curvature,and double eyelid condition,between the two groups(P>0.05).The incidence of surgical complications in the observation group(4.31%)was lower than that in the control group(7.03%),but the difference was not statistically significant(P>0.05).Patient satisfaction in the observation group(94.03%)was significantly higher than that in the control group(80.00%),P<0.05.Conclusion The modified CFS suspension combined with LM complex tension-free shortening correction is associated with better correction rates,eyelid closure degree,and patient satisfaction in the treatment of severe ptosis,with a lower incidence of surgical complications,and is worth promoting and applying.

关 键 词：重度上睑下垂 联合筋膜鞘悬吊术 上睑提肌缩短术 额肌瓣悬吊术 改良术式 效果比较 

分 类 号：R47[医药卫生—护理学]