切开法重睑成形术后并发症预防及处理.doc

切开法重睑成形术后并发症预防及处理[摘要]目的：探讨切开法重睑成形术后并发症的预防及处理。方法：注重手术每一环节的细节处理技术并注重整体把握的处理策略行重睑成形术162例，其中合并内眦赘皮47例，上睑脂肪较多30例，上睑皮肤松弛17例，泪腺脱垂6例，14例为第2次手术，5例为第4次手术。年龄17～61岁，平均29岁，男17例，女145例。结果：所有就医者麻醉满意，各手术操作步骤动作到位，稳、准、轻、快，术后无感染，切口一期愈合。重睑中间部分距睑缘平均宽度为（7.50±0.80）mm，重睑线自然流畅，闭眼时切痕不明显，两侧的对称性较好。结论：注重切开法重睑成形术的操作细节并整体把握对取得自然的重睑效果非常重要，可显著减少术后并发症。 [关键词]睑成形术；重睑；并发症；预防；处理 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）06-0895-03 Prevention and treatment of complications of blepharoplasty for double eyelids SHI Wen-guo,GUO Zong-ke,YU Bing,MA Xiao-jun （Department of Plastic Surgery,Affiliated ZhongdaHospital,Southeast University,Nanjing 210009,China） Abstract:ObjectiveTo investigate the prevention and the treatment of the complications of blepharoplasty for double eyelids.MethodsWith the comprehensive grasp of operational details,162 cases, who were 17 to 61 years old with average 29 years,men 17 cases and women 145 cases,were performed blepharoplasty for double eyelids.ResultsAll of these patients underwent these perfect procedures with satisfied anesthesia.Incisions were all healed in one stage with no infection. Double eyelid width were（7.50±0.80）mm with natural and smooth linesafter 3 monthsoperation, slight scars and good bilateral symmetry.ConclusionsIn order to achieve the natural and smooth double eyelids,it is important for plastic surgeons to have the comprehensive grasp of operational details in blepharoplasty for double eyelids. Key words:blepharoplasty; double eyelids;complications; prevention;treatment 切开法重睑成形术可以调节上睑各个层次的组织结构，适应证较广，是临床上重睑成形术的主要术式[1]。对重睑的开扇形、平行形及弯月形三种[2]基本形态的把握以及重睑线的设计，整形美容外科医生多感到难度不大，但对如何达到重睑线一侧的流畅性、两侧的对称性，形成在面部这一整体中协调、美观自然的重睑，多感到难度较大。有人注重术前重睑线的设计，有人注重睑板前组织的去除，有人注重皮肤与睑板等的穿挂，但术后效果有时候仍然不理想，与医生或就医者的期望值仍然有差距，甚至有部分医生对这种传统的大切口切开法重睑成形术抱有畏惧心理，把注意力更多地集中于短切口法、三切口法及两切口法的重睑成形术。我们通过对手术操作细节的整体把握，使手术操作每一步都尽量到位而最终实现重睑设计的理念，显著减少了术后并发症，临床上取得满意效果，现报道如下。 1资料和方法 1.1 一般资料：本组162例，合并内眦赘皮47例，上睑脂肪较多30例，上睑皮肤松弛17例，泪腺脱垂6例，14例为第2次手术，5例为第4次手术，同时进行下睑袋矫正术21例。年龄17～61岁，平均29岁，男，15例