双层次定位设计缝合法在重睑成形术中应用.doc

双层次定位设计缝合法在重睑成形术中应用[摘要]目的：探?在重睑成形术中，如何将重睑切口线与挂缝睑板层定位弧线精确对应，从而形成优美传神的重睑。方法：从皮肤、睑板二个层面综合设计重睑切口线、皮肤及对应睑板的缝合点，将其进行皮下、皮面双层与睑板缝合形成稳妥粘连，使皮面的重睑弧线与对应睑板缝合点相对应。结果：采用该方法行重睑术的患者，无一例出现双侧重睑宽度不一、重睑皱襞中断或消失，多重睑及皮下结节等并发症，随访的所有病例，均对手术效果满意。结论：应用双层次定位设计缝合法行重睑术，并发症少，重睑线形态自然流畅，患者满意度高，值得临床推广应用。 [关键词]重睑成形术；双层次定位；缝合法 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）09-1342-02 Application of two levels localization design and suture in duplication blepharoplasty ZHANG An-li,HUANG Ze-chun,YAN Dan,LIANG Zhi-wei,TANG Hong-wei,LI Shi-feng (Department of Plastic and Cosmetic Surgery,The First People’s Hospital of Chenzhou,Chenzhou 423000,Hunan,China) Abstract:ObjectiveTo discuss the surgical skill which can achieve vivid double eyelid through accurate location of double eyelid line and tarsal plate in the procedure of duplication blepharoplasty.MethodsThe double eyelid line and corresponding tarsal suture site were two levels localization via skin,conjunctiva and tarsal plate，then the skin on double eyelid line were suture fixed to corresponding tarsal site so that stable adhere between skin and arsal plate formed. ResultsAll the cases were satisfactory with the surgical effect,and there were no complications of double-eyelid asymmetry, discontinuance or disappearance,multi-eyelid andsubcutaneous nodule etc.ConclusionsTwo levels localization design and suture for duplication blepharoplasty have the advantage of high efficacy and fewer side effects,it can make satisfactory cosmetic effect and is worthy of wide clinical application. Key words:duplication blepharoplasty;two levels localization; suture 由于东方民族的眼形特点,单睑较多,重睑术占美容手术很大比重。尽管切开重睑术式已定型，但由于各人眼型及上睑松弛程度不同及手术操作者水平有高低，故术后仍有较高的并发症[1-3]发生。美容初学者对上睑的解剖及手术操作的熟练程度不够，术后常出现形态不自然、双侧不对称、重睑过高、重睑皱襞不全、消失等各种不理想现象。为有效降低这些并发症的发生，近两年来，我科采用双层次定位设计缝合法行切开重睑术，取得了良好的效果。 1资料和方法 1.1一般资料：本组50例患者,其中男性为8例，女性42例;年龄18～52岁，同期行内眦整形术者为20例，均采用切开重睑术。 1.2重睑线的设计：术前根据患者上睑的解剖特点，个性化制定重睑切口的高度和形状。患者微闭眼，翻转上眼睑,以直尺在上睑结膜面测量睑板最高点至上睑游离缘的垂直距离为睑板高度，将睑板高度减去1～2mm，在瞳孔正上方皮肤面的定点