改良Z成形术在重度内眦赘皮矫治中应用探究.docVIP

改良Z成形术在重度内眦赘皮矫治中应用探究[摘要]目的：探讨重度内眦赘皮矫正的较佳手术设计方法。方法：利用Z成形术的基本原理，对Z字上下臂及中轴线的位置、形态、方向、大小及侧臂与长轴夹角等多方面进行改良设计，明确固定标志，形成完整的、合理的重度内眦赘皮手术设计方案。结果：本组29例患者，经6～12个月随访，术后赘皮消失、泪阜外露适度、睑裂开大并与内眦间距比例协调、内眦角形态良好、睑裂美观自然，所有患者内眦处手术痕迹不显。结论：本改良Z成形术矫治重度内眦赘皮的方法，具有术后效果好、无复发、手术痕迹不显，同时标志点明确、操作简单、易于掌握，具有一定的临床应用价值。 [关键词]重度内眦赘皮；改良Z成形术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）01-0039-03 Application research on severe epicanthoplasty by method of modified Z plasty MENG Ling-jun1，NIU Lei1，DAI Jin-rong2，ZHANG Jiang3，HUANG Zhi-lin1，WANG Xiu-jin1 （1.Department of Plastic ＆ Aesthetic Surgery,Tangshan Workers Hospital,Tangshan 063000，Hebei，China；2.Tangshan Jinrong Hospital；3. The 8th Hospital of Tangshan） Abstract:ObjectiveTo investigate a good way of design for correction of severe epicanthal fold.MethodsBy applying its basic theorem,we concisely designed Z plasty, in which the central axis,upper and lower arms are each adjusted according to its position,shape,direction,size and included angle. After affixing markers, intact and rational design proposal was yielded. Results After 6～12 months follow-up,29 cases in the group manifested good results with no obvious scar, and palpebral fissure, lacrimal caruncle,angle of eye medial are in harmony. Conclusion The resultant scar is mild and relapse-free with no trail of operation. The results obtained by using modified Z plasty for epicanthoplasty are very satisfactory. We propose the clinical use of this technique for correction of epicanthal deformities with simplified manipulation and cosmetic effect. Key words:severe epicanthus;modified Z-plasty 重度先天性内眦赘皮的矫正通常采用Mustarde法，但此方法手术后瘢痕十分明显，效果往往不尽人意。一直以来，许多专家学者对重度内眦赘皮治疗的方法不断地进行研究和探索，希望能找到一个较为理想的治疗方案。2005年以来，我科采用改良单Z成形术的手术设计方法治疗重度内眦赘皮，临床上取得了十分良好的治疗效果。 1临床资料 本组重度先天性内眦赘皮共29例，年龄18～41岁，其中女27例，男2例，24例为双侧内眦赘皮，5例为一侧重度，另一侧为中度，单睑者27例，重睑者2例。随访时间6月～1年。内眦赘皮伴单睑者均同期行重睑成形术。 2手术方法 2.1术前设计：设计改良单Z成形术，并以1%龙胆紫或美蓝画线标出。先自内眦向外眦沿重睑线或设计重睑切口线，于眼内角点相对应部位的内侧2mm 处稍下方设A点，其水平高度位于睑裂水平线下1mm处；在重睑线与内眦赘皮相交汇处设B点；自B点向下