摘要
目的比较提上睑肌缩短术(LMR)与联合筋膜鞘悬吊术(CFSS)治疗重度上睑下垂的临床效果。方法随机对照研究。抽取2020年1月至2023年4月开封市中心医院、河南整形美容医院及上海交通大学医学院附属第九人民医院收治的重度上睑下垂患者54例,按随机数字表法分为CFSS组与LMR组,每组27例。CFSS组采用CFSS进行治疗,LMR组采用LMR进行治疗。比较两组矫正效果、上睑回退量、上睑活动范围、角膜损害程度[角膜荧光素染色(FL)评分]、眼部外观复常时间、并发症发生率。结果CFSS组矫正效果优于LMR组(P<0.05)。术后4周,CFSS组上睑回退量少于LMR组,上睑活动范围大于LMR组(P<0.05)。术后3 d,两组FL评分均较同组术前增高,但CFSS组低于LMR组(P<0.05)。CFSS组眼部外观复常时间短于LMR组(P<0.05)。CFSS组并发症发生率(7.41%,2/27)低于LMR组(29.63%,8/27),P<0.05。结论与LMR相比,CFSS治疗重度上睑下垂可提高矫正效果,减少上睑回退量、扩大上睑活动范围,并能减轻角膜损害,降低并发症发生率。
Objective To compare the effects of levator muscle resection(LMR)and conjoint fascial sheath suspension(CFSS)in the treatment of severe blepharoptosis.Methods This study was a randomized controlled trial.A total of 54 patients with severe blepharoptosis admitted to Kaifeng Central Hospital,Henan Cosmetic Surgery Hospital and the the Ninth People’s Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University from January 2020 to April 2023 were selected,and they were divided into CFSS group and LMR group by random number table method,with 27 cases in each group.The CFSS group was treated by CFSS,while the LMR group was treated by LMR.The correction effect,amount of upper eyelid retraction,range of upper eyelid movement,degree of corneal damage evaluated by fluorescein staining(FL)score,time for ocular appearance normalization and incidence of complications were compared between the two groups.Results The correction effect of the CFSS group was better than that of the LMR group(P<0.05).At 4 weeks after operation,the amount of upper eyelid retraction in the CFSS group was less than that in the LMR group,and the range of upper eyelid movement was greater than that in the LMR group(P<0.05).At 3 days after operation,the FL scores of both groups increased compared with the same group before surgery,but the FL score of the CFSS group was lower than that of the LMR group(P<0.05).The time for ocular appearance normalization in the CFSS group was shorter than that in the LMR group(P<0.05).The incidence of complications in the CFSS group was 7.41%(2/27),lower than the 29.63%(8/27)in the LMR group(P<0.05).Conclusions Compared with LMR,CFSS in the treatment of severe blepharoptosis can improve the correction effect,reduce the amount of upper eyelid retraction,expand the range of motion of the upper eyelid,reduce corneal damage,and reduce the incidence of complications.
作者
金铭
张正文
李华强
俞哲元
张秀叶
Jin Ming;Zhang Zhengwen;Li Huaqiang;Yu Zheyuan;Zhang Xiuye(Department of Plastic Surgery,Kaifeng Central Hospital,Kaifeng 475004,China;Henan Cosmetic Surgery Hospital,Zhengzhou 450000,China;Department of Plastic Surgery,the Ninth People’s Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University,Shanghai 200020,China)
出处
《中国实用医刊》
2024年第4期37-40,共4页
Chinese Journal of Practical Medicine
