不同程度上睑松弛合并眉下垂手术设计.docVIP

不同程度上睑松弛合并眉下垂的手术设计 　　[摘要]目的：介绍不同程度上睑松弛合并眉下垂的手术设计与应用效果。方法：根据上睑松弛与眉下垂的程度行个性化设计。手术切除眉上或眉下及上睑部分皮肤肌肉层、内缝线固定悬吊松弛的眼轮匝肌等矫正不同程度的上睑松弛及眉下垂。结果：所有受术者切口均一期愈合，80%眉形及上睑缘弧度柔和且两侧基本一致，无成角畸形、睑外翻及睑裂闭合不全等并发症，约20%有不同程度复发，行二次修复后患者满意。结论：不同程度的上睑松弛及眉下垂的手术需行个体化设计才能达到预期效果。 　　[关键词]不同程度；上睑松弛；眉下垂；手术设计；眼整形术 　　[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2015）18-0020-03 　　The surgical design of different degree eyebrow ptosis with upper eyelid skin relaxation 　　ZHOU Su-mei，HAN Jian-peng 　　（Department of Ophthalmology，The Sixth Peoples Hospital of Nantong，Nantong 226001，Jiangsu，China） 　　Abstract： Objective To introduce the surgical design of different degree eyebrow ptosis with upper eyelid skin relaxation. Methods Individualization surgical design for patients based on the different degrees of eyebrow ptosis and upper eyelid skin relaxation.According to the different degree eyebrow ptosis with upper eyelid skin relaxation，we resected the portion of skin and muscle of lower eyebrow and upper eyebrow simultaneous suture fixation relaxation of orbicularis oculi muscle. Results All incisions of patients were with primary healing.The shape of eyebrow and upper eyelid radian were satisfied with the 80%patients and the shape of eyebrow and upper eyelid radian are consistent in both sides.There were no complications of ectropion，blepharal dysraphism and angulation deformity.About 20%patients have different degrees of recurrence and they are satisfaction after the second surgical. Conclusion It is necessary to operate individualization surgical design for patients with different degrees of eyebrow ptosis and upper eyelid skin relaxation. 　　Key words：different degrees；upper eyelid skin relaxation；eyebrow ptosis；surgical design；ophthalmoplasty 　　眉下垂及上睑松弛绝大部分是因为年龄因素，中老年人整个面部皮肤及表浅肌肉腱膜系统（SMAS）随年龄增长逐渐老化松弛下垂，部分因眼睑血管神经性水肿，眶脂肪向前突垂，上睑提肌腱膜变性松弛，重症肌无力，面瘫及先天性遗传因素等所致。轻中度眉下垂上睑松弛给人以面部老相及精神气不足的外观感觉，重度者遮盖视野，影响视力。随着社会老龄化及物质生活水平的提高，不少中老年人开始重视自身的容貌问题。笔者就不同程度上睑松弛合并眉下垂的手术矫正做一些临床分析。 　　1 临床资料 　　本组病例为2010年1月-2014年12月就诊的双上睑松弛合并眉下垂者