改良额肌瓣悬吊术治疗儿童先天性重度上睑下垂24例(1)
[摘要] 目的 研究改良额肌瓣悬吊术治疗儿童先天性重度上睑下垂的效果。方法 方便选取2016年7月—2018年7月该院收治的患有先天性重度上睑下垂的儿童24例(29眼)，并且将患者分为观察组和对照组，每组患者12例。观察组采用改良额肌瓣悬吊术进行治疗，对照组采用常规治疗，分析其治疗效果以及患者年龄段与恢复时间对比情况。 结果 研究结果显示，观察组的治疗效果高于对照组(χ2=5.042 0，P=0.024 7)，所有患者的年龄段与恢复时间之间差异无统计学意义(P>0.05)。 结论 改良额肌瓣悬吊术在治疗儿童先天性重度上睑下垂中效果较好，对患者损伤较小具一定临床应用与研究价值。
[关键词] 额肌瓣悬吊术;儿童;上睑下垂
[中图分类号] R779 [文献标识码] A [文章编号] 1674-0742(2019)07(a)-0028-03
Modified Frontal Muscle Flap Suspension for the Treatment of Congenital Severe Ptosis in Children： a Report of 24 Cases
ZHOU Ming-di
Zhaotong Second People's Hospital， Zhaotong， Yunnan Province， 657000 China
[Abstract] Objective To study the effect of modified frontal muscle flap suspension in the treatment of children with congenital severe ptosis. Methods Twenty-four children (29 eyes) with congenital severe ptosis were convenient enrolled in our hospital from July 2016 to July 2018. The patients were divided into observation group and control group， with 12 patients in each group. The observation group was treated with modified frontal muscle suspension. The control group was treated with conventional therapy， and the treatment effect and the age of the patient and the recovery time were analyzed. Results The results of the study showed that the treatment effect of the observation group was higher than that of the control group(χ2=5.042 0， P=0.024 7). There was no statistically significant difference between the age group and the recovery time of all patients(P>0.05). Conclusion The improved frontal muscle flap suspension has a better effect in the treatment of congenital severe ptosis in children， and it has certain clinical application and research value.
[Key words] Frontal muscle flap suspension; Child; Ptosis
上瞼下垂系指提上睑肌和Müller平滑肌的功能不全或丧失，以致上睑呈现部分或全部下垂，常伴有患者习惯性的皱额、耸肩及仰头视物[1]。眼睑皮肤的下垂，以及睫毛的垂直向下，可遮盖部分瞳孔，导致视觉昏暗，视物不清或疲乏，不仅影响患者美观及生活质量，重者可能导致弱视，影响视功能。对于先天性上睑下垂患者，建议儿童时期进行手术治疗[2-3]。儿童上睑下垂手术分为两大类，提上睑肌缩和额肌悬吊。额肌悬吊手术不会损伤组织，手术安全，术后眼型好，比较适合儿童[4-5]。该研究以24例(29眼)先天性重度上睑下垂的儿童为对象，病例时间在2016年7月—2018年7月，对其进行改良额肌瓣悬吊术治疗并分析治疗效果。现报道如下。
1 资料与方法
1.1 一般资料
方便选取该院收治的患有先天性重度上睑下垂的儿童24例作为研究对象，分为观察组和对照组，每组患者12人。观察组使用改良额肌瓣悬吊术进行治疗，对照组使用常规治疗。在这24例患儿中，患有单眼19例，双眼5例，共29眼。所有患者年龄为4～14岁，平均6.5岁。差异无统计学意义(P>0.05)，基础资料具有可比性。
1.2 临床纳入与排除标准[6]
①经诊断符合先天性重度上睑下垂症状;②排除明显瘢痕体质者;③无遗传病史或重大疾病史;④患者对手术治疗药物无过敏史以及服用禁忌症;⑤治疗研究征得患者同意，且签署同意书，该研究所选病例已经经过伦理委员会批准[6]。, 百拇医药(周明棣)
[关键词] 额肌瓣悬吊术;儿童;上睑下垂
[中图分类号] R779 [文献标识码] A [文章编号] 1674-0742(2019)07(a)-0028-03
Modified Frontal Muscle Flap Suspension for the Treatment of Congenital Severe Ptosis in Children： a Report of 24 Cases
ZHOU Ming-di
Zhaotong Second People's Hospital， Zhaotong， Yunnan Province， 657000 China
[Abstract] Objective To study the effect of modified frontal muscle flap suspension in the treatment of children with congenital severe ptosis. Methods Twenty-four children (29 eyes) with congenital severe ptosis were convenient enrolled in our hospital from July 2016 to July 2018. The patients were divided into observation group and control group， with 12 patients in each group. The observation group was treated with modified frontal muscle suspension. The control group was treated with conventional therapy， and the treatment effect and the age of the patient and the recovery time were analyzed. Results The results of the study showed that the treatment effect of the observation group was higher than that of the control group(χ2=5.042 0， P=0.024 7). There was no statistically significant difference between the age group and the recovery time of all patients(P>0.05). Conclusion The improved frontal muscle flap suspension has a better effect in the treatment of congenital severe ptosis in children， and it has certain clinical application and research value.
[Key words] Frontal muscle flap suspension; Child; Ptosis
上瞼下垂系指提上睑肌和Müller平滑肌的功能不全或丧失，以致上睑呈现部分或全部下垂，常伴有患者习惯性的皱额、耸肩及仰头视物[1]。眼睑皮肤的下垂，以及睫毛的垂直向下，可遮盖部分瞳孔，导致视觉昏暗，视物不清或疲乏，不仅影响患者美观及生活质量，重者可能导致弱视，影响视功能。对于先天性上睑下垂患者，建议儿童时期进行手术治疗[2-3]。儿童上睑下垂手术分为两大类，提上睑肌缩和额肌悬吊。额肌悬吊手术不会损伤组织，手术安全，术后眼型好，比较适合儿童[4-5]。该研究以24例(29眼)先天性重度上睑下垂的儿童为对象，病例时间在2016年7月—2018年7月，对其进行改良额肌瓣悬吊术治疗并分析治疗效果。现报道如下。
1 资料与方法
1.1 一般资料
方便选取该院收治的患有先天性重度上睑下垂的儿童24例作为研究对象，分为观察组和对照组，每组患者12人。观察组使用改良额肌瓣悬吊术进行治疗，对照组使用常规治疗。在这24例患儿中，患有单眼19例，双眼5例，共29眼。所有患者年龄为4～14岁，平均6.5岁。差异无统计学意义(P>0.05)，基础资料具有可比性。
1.2 临床纳入与排除标准[6]
①经诊断符合先天性重度上睑下垂症状;②排除明显瘢痕体质者;③无遗传病史或重大疾病史;④患者对手术治疗药物无过敏史以及服用禁忌症;⑤治疗研究征得患者同意，且签署同意书，该研究所选病例已经经过伦理委员会批准[6]。, 百拇医药(周明棣)