经眉下切口前徙眼轮匝肌瓣和自体颗粒脂肪注射矫正不同程度上睑凹陷的临床效果  

Clinical efficacy of anteriorly displaced orbicularis oculi flap and autologous granular fat injection via sub-brow incision for correction of different degrees of sunken upper eyelid

作　　者：胡国强 张杉 陈浩 张天琦 付秋悦 陈刚[2] Hu Guoqiang;Zhang Shan;Chen Hao;Zhang Tianqi;Fu Qiuyue;Chen Gang(Wuxi Xingxi Medical Beauty Clinic,Wuxi 214041,China;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]无锡星馨医疗美容门诊部,无锡214041 [2]江苏省中医院(南京中医药大学附属医院)整形外科,南京210029

出　　处：《中华医学美学美容杂志》2025年第2期110-114,共5页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：江苏省卫生健康委面上项目(BJ20023)。

摘　　要：目的探讨经眉下切口前徙眼轮匝肌瓣和自体颗粒脂肪注射矫正不同程度上睑凹陷的临床效果。方法前瞻性纳入2021年9月至2022年9月江苏省中医院整形外科80例上睑皮肤松弛伴上睑凹陷患者,男18例,女62例,年龄28~60岁,平均年龄(42.7±9.2)岁。根据Park分度法进行分组,Ⅰ、Ⅱ度上睑凹陷组59例,采用提眉术+眼轮匝肌瓣上睑凹陷矫正术治疗;Ⅲ度上睑凹陷组21例,采用提眉术+自体颗粒脂肪填充术治疗。随访6个月,测量患者术前及术后上睑凹陷深度,评价手术疗效。记录患者不良反应发生率和患者满意率。结果所有患者上睑凹陷深度均得到改善。Ⅰ、Ⅱ度上睑凹陷组术前上睑凹陷深度为(6.01±2.25)mm,术后6个月为(2.00±1.06)mm(P=0.001)。Ⅲ度上睑凹陷组术前上睑凹陷深度为(13.15±1.75)mm,术后6个月为(4.15±1.49)mm(P=0.001)。经过6个月随访,患者并发症发生率为6.3%(5/80),满意率为90.0%(72/80)。结论根据上睑凹陷程度选择不同的矫正方法,Ⅰ、Ⅱ度上睑凹陷采用经眉下切口前徙眼轮匝肌瓣矫正,Ⅲ度上睑凹陷采用自体颗粒脂肪注射矫正,临床效果和患者满意率均较高。Objective To investigate the clinical results of anteriorly displaced orbicularis oculi flap and autologous granular fat injections via sub-brow incision for correction of different degrees of sunken upper eyelid.Methods From September 2021 to September 2022,a total of 80 patients with upper eyelid skin laxity and sunken upper eyelid were recruited prospectively from the Department of Plastic Surgery,Jiangsu Province Hospital of Chinese Medicine.There were 18 males and 62 females,aged 28 to 60 years,with a mean age of(42.7±9.2)years.According to Park's method,59 patients with gradeⅠand gradeⅡsunken upper eyelid were treated with eyebrow lifting and orbicularis oculi flap correction,and 21 patients with gradeⅢupper eyelid sunken were treated with eyebrow lifting combined with autologous particles fat filling.The patients were followed up for 6 months.The depth of sunken upper eyelid was measured before and after operation.The incidence of adverse reactions and patient satisfaction were recorded.Results The mean depth of depression measured preoperatively was(6.01±2.25)mm in the gradesⅠandⅡsunken upper eyelid,which was improved to(2.00±1.06)mm at the 6-month postoperative follow-up(P=0.001),and the mean depth of depression was(13.15±1.75)mm in the group of gradeⅢ,which was improved to(4.15±1.49)mm at the 6-month postoperative follow-up(P=0.001).After 6-month follow-up,the incidence of complications was 6.3%(5/80)and the satisfaction rate was 90.0%(72/80).Conclusions Different correction methods should be chosen according to the degree of sunken upper eyelid.GradesⅠandⅡsunken upper eyelid are corrected with orbicularis muscle flap through sub-eyebrow incision,and gradeⅢis corrected with autologous fat injection.Both the clinical effect and patient satisfaction rate are higher.

关 键 词：眼睑 凹陷 眼轮匝肌瓣 眉下切口 上睑皮肤松弛 颗粒脂肪 

分 类 号：R779.6[医药卫生—眼科]