22G针头导引固定法在皮肤入路弓状缘释放眶隔脂肪重置术中的应用  

Application of 22G needle-guided suture to transcutaneous orbital septum fat release and transposition over the orbital rim

作　　者：李庆华[1] 高琼 曾光伟 黄新建 徐永飞 陈爽 任永强[1] Li Qinghua;Gao Qiong;Zeng Guangwei;Huang Xinjian;Xu Yongfei;Chen Shuang;Ren Yongqiang(Department of Burn and Plastic Surgery,the First Affiliated Hospital,College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院烧伤整形美容科,洛阳471003

出　　处：《中华整形外科杂志》2025年第1期32-37,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨眶隔脂肪弓状缘释放,22G针头导引固定眶隔脂肪瓣的可行性及其效果。方法回顾性分析2022年1月至2023年11月河南科技大学第一附属医院烧伤整形美容科收治的下睑袋合并泪槽凹陷畸形的患者资料。对患者采用离断泪槽-眼轮匝肌支持韧带、弓状缘释放眶隔脂肪,经22G针头导引,于骨膜上固定眶隔脂肪瓣以改善下睑袋合并泪槽凹陷畸形。术后随访并发症发生情况,采用Hirmand标准对泪槽凹陷进行分型(无泪槽凹陷,Ⅰ级,Ⅱ级,Ⅲ级)和对下睑袋分度(无下睑袋,轻度,中度,重度)评估手术效果;患者采用视觉模拟评分法评价满意度(非常不满意、不满意、一般、满意、非常满意)。结果共纳入32例患者(64个眼睑),男2例,女30例;年龄31~62岁,平均50.2岁。术后随访6~12个月,平均7个月,所有患者均未出现下睑外翻、下睑退缩、瘢痕增生、复视等严重并发症,4例出现轻度睑球分离,2例出现结膜水肿,均于1个月内恢复;眶隔脂肪膨出、泪槽凹陷畸形、下睑皮肤松弛较术前明显改善。术后满意22例,非常满意10例,总满意率100%(32/32)。结论采用22G针头导引固定眶隔脂肪瓣矫正下睑袋合并泪槽凹陷畸形简单可行、术后效果良好。ObjectiveTo explore and analyze the feasibility and efficacy of the 22G needle-guided suture for orbital septum fat flap fixation on the periosteum.MethodsThe retrospective study was conducted.From January 2022 to November 2023,patients with tear trough deformity and eyelid bags underwent surgery of releasing the orbicularis retaining ligament(ORL)complex,orbital septum fat pad combined with 22G needle-guided suture in Department of Burn and Plastic Surgery,the First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology.Postoperative follow-up was conducted to observe the occurrence of complications.The lacrimal depression deformity was classified according to the Hirmand standard and the degree of lower eyelid bags was graded to evaluate the surgical outcome.Patients were evaluated their satisfaction using the visual analogue scale(very dissatisfied,dissatisfied,average,satisfied,very satisfied).ResultsA total of 32 patients(30 females and 2 males)were included in this study.The age range was 31-62 years old with an average of 50.2 years.All patients were followed up for 6 months postoperatively.None of the patients had any severe complications,such as inferior eyelid ectropion,inferior eyelid retraction,scar hyperplasia,and diplopia.Four patients showed mild eyelid-eyeball separation,two patients had conjunctival edema,and all recovered in 1 month.The orbital fat protrusion,tear trough depression deformity,and lower eyelid skin laxity were significantly improved compared to before the operation.Postoperative satisfaction was 22 cases,very satisfied 10 cases,and patient satisfaction rate was 100%(32/32)after surgery.ConclusionThe method of 22G needle-guided suture to fix orbital septum fat pad represents a technically feasible,easy,and suitable for promotion.

关 键 词：下睑袋 泪槽畸形 下睑成形术 眶隔脂肪 22G针头导引固定法 

分 类 号：R779.6[医药卫生—眼科]