摘要
目的:探讨眉下切口提眉术中,采用中央下蒂法眼轮匝肌瓣折叠填充矫正上睑凹陷的效果。方法:2020年8月至2022年4月,空军军医大学第一附属医院整形外科收治上睑皮肤松弛伴凹陷的女性患者39例,年龄36~63(47.1±6.3)岁。提眉术中保留皮肤切除区域眼轮匝肌,并形成以切口下缘中央部为蒂的肌瓣,向深面反折填充于眶隔前间隙,术后6个月采用Park法分级标准比较手术前后效果,并分别由医师和患者按全球审美改善量表进行评分。结果:术后1例患者出现单侧上睑血肿,局部针刺抽吸后愈合。2例患者出现单侧切口单发硬结,随访6个月逐渐消失。其余患者伤口均一期愈合。39例患者均随访6~12个月,术后6个月全球审美改善量表评分显示,医师(4.12±0.95)分、患者(3.82±1.27)分;Park法评估显示术后上睑凹陷矫正程度明显优于术前,差异有统计学意义(Z=-7.72,P<0.001)。结论:眉下切口提眉术中用中央下蒂法眼轮匝肌瓣折叠填充能在矫正上睑皮肤松弛的同时较好地改善患者上睑凹陷,该术式能充分利用局部组织,简单易行,效果确切持久。
Objective To investigate the effect of folding and filling the orbicularis muscle flap of the inferiorcentral pedicle in correction of sunken upper eyelids.Methods From August 2020 to April 2022,39 female patients aged 36-63(47.1±6.3)years with dermatochalasis and sunken upper eyelid were admitted to the Plastic Surgery Department of the First Affiliated Hospital of Air Force Medical University.During the surgery,the orbicularis oculi muscle in the skin resection area was preserved and a muscle flap was formed with the central part of the lower margin of the incision as the pedicle,which was folded deep and filled in the anterior orbital septal space.6 months after surgery,the Park method was used to compare the effects before and after surgery,and the doctors and patients were scored on the Global Aesthetic Improvement Scale,respectively.Results Unilateral upper eyelid hematoma appeared in 1 patient and healed after local acupuncture and aspiration,unilateral incision induration appeared in 2 patients,and gradually disappeared after 6 months of follow-up.The wounds of other patients healed in one stage.All the 39 patients were followed up for 6-12 months.The scores of the Global Aesthetic Improvement Scale at 6 months after surgery were(4.12±0.95)for doctors and(3.82±1.27)for patients.Park method showed that the degree of sunken upper eyelid after surgery was significantly better than that before surgery,and the difference was statistically significant(Z=-7.721,P=0.000).Conclusions The folding and filling of the orbicularis muscle flap of the eye with the inferior central pedicle can correct the laxity of the upper eyelid and improve the sunken upper eyelid.This operation can make full use of local tissue,and the effect is simple and lasting.
作者
刘恒鑫
王嘉阳
牟思琦
张仔昂
张曦
Liu Hengxin;Wang Jiayang;Mu Siqi;Zhang Ziang;Zhang Xi(Department of Plastic Surgery,the First Affiliated Hospital,Air Force Medical University,xi′an 710032,China)
出处
《中华医学美学美容杂志》
2024年第1期56-60,共5页
Chinese Journal of Medical Aesthetics and Cosmetology
关键词
眼睑成形术
中央下蒂
眼轮匝肌瓣
上睑凹陷
皮肤松弛
Blepharoplasty
Inferior central pedicle
Orbicularis oculi muscle flap
Sunken upper eyelid
Dermatochalasis
