外用大黄芒硝粉促进重睑术后恢复的临床研究
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摘要
目的观察大黄芒硝粉药包局部外敷促进重睑术后恢复的临床效果。方法本组共60例,选自2018年10月至2019年3月期间,于江苏省中医院美容整形外科就诊的单睑求美者,要求行重睑成形术及内眦赘皮矫正术。均为女性,年龄在18-30岁之间,平均年龄24岁。将其随机分为治疗组和对照组,每组30例(60只眼)。手术均由同一位医生操作完成,术式均采取真皮眼轮匝肌瓣-睑板前筋膜内固定法和倒"L"法。研究方法:治疗组案例术后采用眼周局部大黄芒硝粉药包间断外敷7天,术后第1天间断冰敷;对照组案例术后间断冰敷1天,研究期内不做其他处理。将治疗组和对照组数据进行统计学分析。结果治疗组和对照组在术后第7天的中间线宽度和眼周组织肿胀评分有显著差异,P <0.05,有统计学意义。切口愈合情况:治疗组甲级愈合率高。疗效评定:治疗组显效率95%,有效率高达98.3%。大黄芒硝粉药包使用期间,未出现过敏、切口或结膜刺激及其他不良反应。结论重睑术后使用大黄芒硝粉药包外敷可以有效促进重睑术后软组织肿胀的恢复,有利于切口愈合,缩短术后恢复期。此治疗方式求美者依从性好,有较明显的临床效果,费用低,有一定的临床意义。
Objective To investigate the clinical effect of local external application of rhubarb and mirabilite powder package in accelerating the recovery after upper blepharoplasty. Methods A total of 60 cases of patients with single eyelid admitted to the cosmetic and plastic surgery department of Jiangsu Province Hospital of TCM from October 2018 to March 2019 were prepared for upper blepharoplasty. All the patients are female, aged between 18 and 30 years old(average 24). They were randomly divided into the treatment group and the control group, with 30 cases(60 eyelids) in each group. All the surgeries were performed by the same doctor, the operative methods were the internal fixation of dermal orbicularis oculi muscle flap and pretarsal fascia, inverted L epicanthoplasty. The intraoperative hemostasis was consistent. The highest point of the double eyelid line was marked by the suture for postoperative measurement. The incision was covered with gauze, the stitches were removed 7 days after the surgery. Local rhubarb and mirabilite powder was applied for 7 days(10-15 min each time, 4-6 times a day), and ice compress was intermittent on the first day postoperatively, in reatment group. Patients received intermittent ice compress for 1 day after surgery, and no other treatment was performed during the study period, in control group. Data collection: patients were placed in supine position with closed eyes. The data of the treatment group and the control group were statistically analyzed. Results On the 7 th day after surgery, there were significant differences in double eyelid line width and the swelling scores of the periocular tissues between the two groups, which was statistically significant. Wound healing: in the treatment group, there were 30 cases(60 eyelids), and 57 cases with grade A healing, other cases with grade B healing, in the control group, 52 cases with grade A healing and 8 cases healed with grade B. The significant effect rate of the treatment group was 95%, and the effective rate was up to 98.3%, both better than the control group 85%,95%. During the use of rhubarb and mirabilite powder package, there was no allergy, incision or conjunctiva irritation, no other adverse reactions, and the clinical effect was obviously. Conclusions External application of rhubarb and mirabilite powder package after upper blepharoplasty can effectively accelerate the recovery of soft tissue swelling, which is conducive to wound healing and shortening the postoperative recovery period. This treatment method has good patient compliance, obvious clinical effect and low cost, so it has certain clinical significance.
Objective To investigate the clinical effect of local external application of rhubarb and mirabilite powder package in accelerating the recovery after upper blepharoplasty. Methods A total of 60 cases of patients with single eyelid admitted to the cosmetic and plastic surgery department of Jiangsu Province Hospital of TCM from October 2018 to March 2019 were prepared for upper blepharoplasty. All the patients are female, aged between 18 and 30 years old(average 24). They were randomly divided into the treatment group and the control group, with 30 cases(60 eyelids) in each group. All the surgeries were performed by the same doctor, the operative methods were the internal fixation of dermal orbicularis oculi muscle flap and pretarsal fascia, inverted L epicanthoplasty. The intraoperative hemostasis was consistent. The highest point of the double eyelid line was marked by the suture for postoperative measurement. The incision was covered with gauze, the stitches were removed 7 days after the surgery. Local rhubarb and mirabilite powder was applied for 7 days(10-15 min each time, 4-6 times a day), and ice compress was intermittent on the first day postoperatively, in reatment group. Patients received intermittent ice compress for 1 day after surgery, and no other treatment was performed during the study period, in control group. Data collection: patients were placed in supine position with closed eyes. The data of the treatment group and the control group were statistically analyzed. Results On the 7 th day after surgery, there were significant differences in double eyelid line width and the swelling scores of the periocular tissues between the two groups, which was statistically significant. Wound healing: in the treatment group, there were 30 cases(60 eyelids), and 57 cases with grade A healing, other cases with grade B healing, in the control group, 52 cases with grade A healing and 8 cases healed with grade B. The significant effect rate of the treatment group was 95%, and the effective rate was up to 98.3%, both better than the control group 85%,95%. During the use of rhubarb and mirabilite powder package, there was no allergy, incision or conjunctiva irritation, no other adverse reactions, and the clinical effect was obviously. Conclusions External application of rhubarb and mirabilite powder package after upper blepharoplasty can effectively accelerate the recovery of soft tissue swelling, which is conducive to wound healing and shortening the postoperative recovery period. This treatment method has good patient compliance, obvious clinical effect and low cost, so it has certain clinical significance.
引文
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[8]苏晓光,张锤,张春莉,等.马栗种子提取物治疗隆鼻术和重睑术后肿胀的疗效观察[J].河北医科大学学报,2011,32(04):406-408.DOI:10.3969/j.issn.1007.3205.2011.04.015
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[11]王娅,曽令寰,曽传秀.自拟食疗方促进重睑成形术后肿胀恢复的疗效观察[J].四川中医,2017,35(09):186-187.
[12]徐定华.大黄、芒硝封包辅助治疗肢体肿胀效果观察[J].光明中医,2016,31(20):3024-3025.DOI:10.3969/j.issn.1003-8914.2016.20.055
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[14]刘莎.芒硝溶液对于大鼠机械性皮损作用的实验研究[D].长春中医药大学,2015.
[15]刘飞.芒硝外用在创面愈合中的作用及机制的研究[D].西南医科大学,2018.
[16]程少晖,程少华.外敷大黄芒硝散的临床应用[J].中国当代医药,2010,17(18):91+95.DOI:10.3969/j.issn.1674-4721.2010.18.058
[2]潘曦晖.重睑术者体像障碍的现况研究及影响因素分析[D].湖南师范大学,2014.
[3]王炜.整形外科学(下)[M].杭州:浙江科学技术出版社,2007:914.
[4]王羽侬,王顺梅,唐莹,等.中医药促进创面愈合机制研究进展[J].中国医药导报,2014,11(19):156-158.
[5]蒙玉娇,何秀娟,林燕,等.回阳生肌膏拆方对慢性皮肤溃疡模型小鼠疮面愈合及疮面巨噬细胞表型转化的影响[J].中医杂志,2017,58(03):244-249.DOI:10.13288/j.11-2166/r.2017.03.017
[6]陈丽.重睑术联合倒L法与Park“Z”法同时矫正内眦赘皮的临床分析[D].昆明医科大学,2017.
[7]曹晔.眼轮匝肌—上睑提肌腱膜固定法重睑术与皮肤—上睑提肌腱膜固定法重睑术的术后肿胀分析对比[D].南昌大学,2017.
[8]苏晓光,张锤,张春莉,等.马栗种子提取物治疗隆鼻术和重睑术后肿胀的疗效观察[J].河北医科大学学报,2011,32(04):406-408.DOI:10.3969/j.issn.1007.3205.2011.04.015
[9]吴在德.外科学[M].7版.北京:人民卫生出版社,2008:132.
[10]徐永成,张煜霖,刘文阁,等.复方银杏叶萃取物胶囊在眼部成形术术后恢复中的应用[J].中华医学美学美容杂志,2014,20(4).DOI:10.3760/cma.j.issn.1671-0290.2014.04.008
[11]王娅,曽令寰,曽传秀.自拟食疗方促进重睑成形术后肿胀恢复的疗效观察[J].四川中医,2017,35(09):186-187.
[12]徐定华.大黄、芒硝封包辅助治疗肢体肿胀效果观察[J].光明中医,2016,31(20):3024-3025.DOI:10.3969/j.issn.1003-8914.2016.20.055
[13]陆雄,杨洋,候大乔,等.中药复方大黄芒硝散外敷的临床应用[J].临床医学研究与实践,2018,3(17):118-119.DOI:10.19347/j.cnki.2096-1413.201817057
[14]刘莎.芒硝溶液对于大鼠机械性皮损作用的实验研究[D].长春中医药大学,2015.
[15]刘飞.芒硝外用在创面愈合中的作用及机制的研究[D].西南医科大学,2018.
[16]程少晖,程少华.外敷大黄芒硝散的临床应用[J].中国当代医药,2010,17(18):91+95.DOI:10.3969/j.issn.1674-4721.2010.18.058