聚丙烯不可吸收缝线额肌悬吊手术:一种治疗老年患者上睑下垂的新方法  

Frontalis sling surgery using polypropylene non-absorbable sutures:a novel approach for the treatment of senile ptosis

作　　者：杨亦 孟雪勇 张骏 黄金龙 Yang Yi;Meng Xueyong;Zhang Jun;Huang Jinlong(Department of Plastic Surgery,Jiangsu Province Hospital of Chinese Medicine,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏省中医院整形外科,南京210029

出　　处：《中华整形外科杂志》2025年第1期8-14,共7页Chinese Journal of Plastic Surgery

基　　金：江苏省中医院优秀青年博士培养专项基金(2024QB015)。

摘　　要：目的探讨利用聚丙烯不可吸收缝线额肌悬吊的方法治疗老年患者上睑下垂的效果。方法回顾性分析2022年1月至2023年12月南京中医药大学附属医院整形外科采用聚丙烯不可吸收缝线额肌悬吊手术治疗的上睑下垂老年患者临床资料。手术前后测量并记录睑裂高度、上睑缘角膜映光距离(MRD1),统计手术时长、术后消肿时间,随访术后并发症及上睑下垂复发情况。调查患者对术后效果的满意度,分为非常满意、满意、不满意3级。正态分布计量资料以±s表示;计数资料以频数表示。结果共纳入8例患者,男3例,女5例,年龄(68.8±6.1)岁;6例接受双侧上睑下垂矫正术,2例接受单侧上睑下垂矫正术;轻度上睑下垂1例,中度2例,重度5例;腱膜性上睑下垂2例,先天性上睑下垂3例,外伤性上睑下垂3例(其中1例为义眼)。8例患者(14侧眼)单侧上睑下垂的手术时间为(43.9±4.9)min,术后消肿时间为(9.4±1.7)d,1例患者术后7 d仍有眼睑闭合不全及角膜刺激症状,予佩戴角膜保护镜及涂抹眼膏后症状逐渐好转。术后随访2~15个月,平均6.3个月。8例患者(14侧眼)术后的睑裂高度[(9.8±0.6)mm比(3.3±1.2)mm]及MRD1[(4.1±0.5)mm比(-1.1±0.8)mm]均较术前明显增加,差异有统计学意义(P均<0.01)。术后未出现上睑下垂复发病例;出现上睑迟滞现象2例,其中1例为轻度上睑迟滞,另1例患者的义眼侧上睑迟滞相对明显。满意度调查显示,患者对手术效果非常满意7例,满意1例。结论聚丙烯不可吸收缝线额肌悬吊术操作简单、组织损伤小、效果肯定、术后恢复快,并发症属可接受程度,是一种治疗老年患者上睑下垂的可行方法。ObjectiveTo investigate the effect of a new method of utilizing frontalis sling with polypropylene non-absorbable sutures for the treatment of senile ptosis.MethodsA retrospective analysis was conducted on the clinical data of senile patients with blepharoptosis who were treated with frontalis sling surgery with polypropylene non-absorbable sutures at the Department of Plastic Surgery,Affiliated Hospital of Nanjing University of Chinese Medicine between January 2022 and December 2023.The palpebral fissure height and margin reflex distance(MRD1)of the upper eyelid margin were measured and recorded before and after the operation,and the operation time and postoperative detumescence time were recorded.Postoperative complications and recurrence of ptosis were followed up.Patients’satisfaction with the postoperative effect was investigated and divided into three levels:very satisfied,satisfied,and dissatisfied.Normal distribution measurement data were expressed as Mean±SD;counting data were expressed as frequency.ResultsA total of 8 patients were enrolled,including 3 males and 5 females,with an age of(68.8±6.1)years.Six patients underwent bilateral ptosis correction surgery,and two underwent unilateral ptosis correction surgery.The ptosis was graded as follows:1 case was mild,2 cases were moderate,and 5 cases were severe.There were 2 cases of aponeurotic ptosis,3 cases of congenital ptosis and 3 cases of traumatic ptosis(1 of which was prosthetic eye).The operative time of 8 patients(14 eyes)with unilateral ptosis was(43.9±4.9)min.The swelling resolved in(9.4±1.7)days.One patient still had symptoms of lagophthalmos and corneal irritation 7 days after the operation.The symptoms gradually relieved after wearing corneal protective goggles and applying eye ointment.The postoperative follow-up lasted from 2 to 15 months(mean 6.3 months).Palpebral cleft height[(9.8±0.6)mm vs.(3.3±1.2)mm]and MRD1[(4.1±0.5)mm vs.(-1.1±0.8)mm]in 8 patients(14 eyes)after surgery were significantly higher than those before the operatio

关 键 词：眼睑下垂 老年人 额肌悬吊术 聚丙烯不可吸收缝线 

分 类 号：R779.6[医药卫生—眼科]