联合筋膜鞘悬吊术治疗中重度上睑下垂(1)
[摘要]目的：探究联合筋膜鞘悬吊术对中重度上睑下垂患者的矫治效果。方法：选取2015年6月-2018年9月在笔者医院手术治疗的中重度上睑下垂患者56例(68眼)，按随机数字表法分为观察组和对照组，每组28例(34眼)，观察组予以联合筋膜鞘悬吊术治疗，对照组予以额肌瓣悬吊术治疗，比较两组患者术后上下眼睑矫正、上睑回退、上睑运动范围、患者满意度和术后并发症等。结果：术后观察组正矫率为94.12%，高于对照组的76.47%，差异有统计学意义(P<0.05)。术后1周、1个月、3个月、6个月时观察组上睑回退长度均低于对照组，上睑活动范围大于对照组(P<0.05)。随访发现，观察组患者在平视和上视时的满意度均高于对照组，且观察组并发症发生率为8.82%低于对照组的29.41%(P<0.05)。结论：联合筋膜鞘悬吊术对中重度上睑下垂患者矫正率较高，术后上睑功能恢复好，活动度较好，且并发症少，患者满意度高，值得临床推荐应用。
[关键词]上睑下垂;联合筋膜鞘悬吊术;额肌瓣悬吊术;中重度;满意度;并发症;矫正率
[中图分类号]R622 [文獻标志码]A [文章编号]1008-6455(2019)10-0044-03
Abstract： Objective To explore the clinical efficacy of conjoint fascial sheath suspension in patients with moderate to severe blepharoptosis. Methods 56 patients (68 eyes) with moderate-severe blepharoptosis during surgery from June 2015 to September 2018 were randomly selected and divided into the observation group [28 patients (34 eyes)]and the control group[28 patients (34 eyes)]， according to a random number table method. The observation group was treated with conjoint fascial sheath suspension. The control group was treated with frontalis muscle flap suspension. The degree of upper and lower eyelid correction， upper eyelid retraction， upper eyelid movement range， and patient satisfaction were compared between the two groups. Results The positive rate of postoperative observation group was 94.12%， which was higher than that of the control group (76.47%)， the difference was statistically significant (P<0.05). At one week， one month， 3 months and 6 months after operation， the length of upper eyelid regression in the observation group was lower than that in the control group， and the range of upper eyelid movement was larger than that in the control group(P<0.05). Follow-up found that the satisfaction of patients in the observation group was higher than that in the control group， and the incidence of complications in the observation group was 8.82% lower than that in the control group (29.41%， P<0.05). Conclusion The conjoint fascial sheath suspension has a higher correction rate in patients with moderate-severe blepharoptosis， better postoperative activity， fewer complications， and high patient satisfaction. It is worthy of clinical application.
Key words： blepharoptosis; conjoint fascial sheath suspension; frontalis muscle flap suspension; moderate to severe; satisfaction; complications; correction rate
因提上睑肌和Müller平滑肌功能不全或丧失，致使上睑部分或全部下垂，严重者可遮挡瞳孔，这种疾病称为上睑下垂。上睑下垂不仅影响患者视力，同时也影响美观[1-2]。按照病情轻重，可对上睑下垂分为轻、中、重三个等级，对于中重度患者临床主要采用手术方式治疗，以往以额肌瓣悬吊术应用最为广泛，但是临床上发现该手术虽然疗效较为持久，但是术后眼睑活动度差、眼睑关闭不全、术后护理时间长等因素使患者接受度较差[3]。近年来逐渐有联合筋膜鞘悬吊术治疗上睑下垂的报道，疗效得到了一定认可[4]，为验证该手术的临床疗效，本次选取56例(68眼)患者，部分行联合筋膜鞘悬吊术治疗，疗效满意。, 百拇医药(刘竟慧 张蕾)
[关键词]上睑下垂;联合筋膜鞘悬吊术;额肌瓣悬吊术;中重度;满意度;并发症;矫正率
[中图分类号]R622 [文獻标志码]A [文章编号]1008-6455(2019)10-0044-03
Abstract： Objective To explore the clinical efficacy of conjoint fascial sheath suspension in patients with moderate to severe blepharoptosis. Methods 56 patients (68 eyes) with moderate-severe blepharoptosis during surgery from June 2015 to September 2018 were randomly selected and divided into the observation group [28 patients (34 eyes)]and the control group[28 patients (34 eyes)]， according to a random number table method. The observation group was treated with conjoint fascial sheath suspension. The control group was treated with frontalis muscle flap suspension. The degree of upper and lower eyelid correction， upper eyelid retraction， upper eyelid movement range， and patient satisfaction were compared between the two groups. Results The positive rate of postoperative observation group was 94.12%， which was higher than that of the control group (76.47%)， the difference was statistically significant (P<0.05). At one week， one month， 3 months and 6 months after operation， the length of upper eyelid regression in the observation group was lower than that in the control group， and the range of upper eyelid movement was larger than that in the control group(P<0.05). Follow-up found that the satisfaction of patients in the observation group was higher than that in the control group， and the incidence of complications in the observation group was 8.82% lower than that in the control group (29.41%， P<0.05). Conclusion The conjoint fascial sheath suspension has a higher correction rate in patients with moderate-severe blepharoptosis， better postoperative activity， fewer complications， and high patient satisfaction. It is worthy of clinical application.
Key words： blepharoptosis; conjoint fascial sheath suspension; frontalis muscle flap suspension; moderate to severe; satisfaction; complications; correction rate
因提上睑肌和Müller平滑肌功能不全或丧失，致使上睑部分或全部下垂，严重者可遮挡瞳孔，这种疾病称为上睑下垂。上睑下垂不仅影响患者视力，同时也影响美观[1-2]。按照病情轻重，可对上睑下垂分为轻、中、重三个等级，对于中重度患者临床主要采用手术方式治疗，以往以额肌瓣悬吊术应用最为广泛，但是临床上发现该手术虽然疗效较为持久，但是术后眼睑活动度差、眼睑关闭不全、术后护理时间长等因素使患者接受度较差[3]。近年来逐渐有联合筋膜鞘悬吊术治疗上睑下垂的报道，疗效得到了一定认可[4]，为验证该手术的临床疗效，本次选取56例(68眼)患者，部分行联合筋膜鞘悬吊术治疗，疗效满意。, 百拇医药(刘竟慧 张蕾)