眼轮匝肌预缝合缩短术在中老年睑袋整复中的应用
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摘要
目的:探讨眼轮匝肌预缝合缩短术在中老年睑袋整复中的效果。方法:将60例做睑袋整复治疗的中老年病人随机分为2组,每组30例,其中,接受传统经皮入路下睑袋整形术者为对照组,接受眼轮匝肌预缝合缩短术者为观察组。观察组在传统的睑袋整形术的基础上,游离眼轮匝肌,在距离外眦角约0.5 cm处作垂直于眼轮匝肌的设计线,沿垂线离断眼轮匝肌,在断端各缝合牵引丝线,预先将一侧断端缝合至另一断端深面,根据轮匝肌的张力,酌情调整缝合位置,当轮匝肌达到较好外形以及张力时,嘱病人睁眼向额部看,观察睑袋整复效果,切除重叠部分,断端精细缝合。最后对比和分析2种治疗方案的疗效差异。结果:术后1年,观察组病人满意度高于对照组(P<0.01)。2组病人并发症差异均无统计学意义(P>0.05)。结论:应用眼轮匝肌预缝合缩短术,能够明显提高治疗效果及病人满意度,值得临床借鉴。
Objective:To investigate the application effects of presuture shortening of orbicularis oculi muscle in blepharoplasty in the middle and old aged patients.Methods:Sixty middle and old aged patients with palpebral bags were randomly divided into the control group and observation group(30 cases each group).The control group was treated with traditional percutaneous lower eyelid blepharoplasty,and the observation group was treated with presuture shortening of orbicularis oculi muscle based on the traditional blepharoplasty.The orbicularis oculi muscle was separated,and the line perpendicular to the orbicularis oculi muscle at a distance of 0.5 cm from the outer canthal angle was designed,the orbicularis oculi muscle was cut off.The traction thread was sutured at the broken end,the one side broken end was sutured into the deep surface of the other end in advance,and the position of suture was adjusted according to the tension of orbicularis muscle.When the orbicularis muscle reached a better shape and tension,the patients were asked to open their eyes to the forehead for observing the effects of blepharoplasty.The overlapping part was excised,and the broken end was finely sutured.The curative effect between two schemes was compared and analyzed.Results:After 1 year of operation,the satisfaction degree in observation group was higher than that in control group(P<0.01).There was no statistical significance in complications between two groups(P>0.05).Conclusions:The application of presuture shortening of orbicularis oculi muscle can significantly improve the treatment effect and satisfaction of patients,which is worthy of promotion.
Objective:To investigate the application effects of presuture shortening of orbicularis oculi muscle in blepharoplasty in the middle and old aged patients.Methods:Sixty middle and old aged patients with palpebral bags were randomly divided into the control group and observation group(30 cases each group).The control group was treated with traditional percutaneous lower eyelid blepharoplasty,and the observation group was treated with presuture shortening of orbicularis oculi muscle based on the traditional blepharoplasty.The orbicularis oculi muscle was separated,and the line perpendicular to the orbicularis oculi muscle at a distance of 0.5 cm from the outer canthal angle was designed,the orbicularis oculi muscle was cut off.The traction thread was sutured at the broken end,the one side broken end was sutured into the deep surface of the other end in advance,and the position of suture was adjusted according to the tension of orbicularis muscle.When the orbicularis muscle reached a better shape and tension,the patients were asked to open their eyes to the forehead for observing the effects of blepharoplasty.The overlapping part was excised,and the broken end was finely sutured.The curative effect between two schemes was compared and analyzed.Results:After 1 year of operation,the satisfaction degree in observation group was higher than that in control group(P<0.01).There was no statistical significance in complications between two groups(P>0.05).Conclusions:The application of presuture shortening of orbicularis oculi muscle can significantly improve the treatment effect and satisfaction of patients,which is worthy of promotion.
引文
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[12] 朱亮,章祥洲.眼轮匝肌缩短及动力重建在中老年眼袋整复中的应用[J].淮海医药,2018.
[2] SHAH MM,STEELE EA,WHITE KP,et al.Syringoid eccrine carcinoma of the eyelid presenting as cicatricial entropion[J].Int J Ophthalmol,2014,7(5):912.
[3] 解永学,张旭东,汪立川,等.1 050例混合型眼袋修复术的临床疗效探讨[J].中华医学美学美容杂志,2010,8(3):198.
[4] 高景恒.美容外科学[M].北京:科学技术出版社,2003:2170.
[5] 徐庆良.松弛皮肤切除加眼轮匝肌缩短术治疗老年性下睑内翻的临床疗效[J].国际眼科杂志,2015,15(7):1277.
[6] 赵延华.双极电凝电烧紧缩眼轮匝肌眼袋整形方法的可行性及效果分析[J].中国医疗器械信息,2016,22(24):117.
[7] 谢波,廖选,卢金强,等.眼轮匝肌缩短睑袋整复术的临床观察[J].中国美容整形外科杂志,2016,27(5):272.
[8] DING J,CHEN F,ZHAI W,et al.Orbicularis oculi muscle transposition for repairing involutional lower eyelid entropion[J].Graefes Arch Clin Exp Ophthalmol,2014,252(8):1315.
[9] 松弛皮肤切除加眼轮匝肌缩短术治疗老年性下睑内翻的临床疗效观察[J].国际眼科杂志,2015,15(7):1277
[10] 董岩,高金莲.眶肌筋膜韧带、眼轮匝肌提紧在睑袋整形术中的应用[J].中国美容医学,2014,23(16):1335.
[11] 杨志祥,王方薪.下眼袋矫正术的体会[J].实用美容整形外科,1994(2):65.
[12] 朱亮,章祥洲.眼轮匝肌缩短及动力重建在中老年眼袋整复中的应用[J].淮海医药,2018.