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睑袋整形术是最常见的面部美容外科手术,主要手术方法包括内入路和外入路两大类型。针对不同的睑袋类型应选择适当的手术方法。由于中、老年人的睑袋形成除了眶隔松弛、脂肪膨出外,均伴有不同程度的下睑皮肤和眼轮匝肌松弛[1-2], 因而在睑袋整复术中,要想获得长久的手术效果,减少睑袋的复发,术中除了去除脂肪和皮肤外,还应加强重建下睑支持结构的作用。在眼轮匝肌的处理上应尤为谨慎,眼轮匝肌预缝合缩短术可避免眼轮匝肌缩短过程中,去除轮匝肌的量过多或过少,对术后效果起着重要作用。我院采用眼轮匝肌预缝合缩短术及传统法治疗中老年人的睑袋,现将这2种方式的临床疗效作一报道。
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2组病人均随访1年,观察组病人满意度高于对照组(P<0.01)(见表 1)。
分组 n 满意 基本满意 不满意 总满意率/% uc P 观察组 30 28 2 0 100.0 6.20 <0.01 对照组 30 19 7 4 86.7 合计 60 47 9 4 93.3 表 1 2组病人满意度情况比较(n)
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术后1年,2组病人并发症发生率差异均无统计学意义(P>0.05)(见表 2)。
分组 睑外翻 血肿 切口感染 1年后眼袋复发 1年后眶周皱纹复发 观察组 0 1 0 0 1 对照组 0 2 1 5 7 χ2 — 0.00 — 3.49 3.61 P — >0.05 >0.05* >0.05 >0.05 *示Fisher′s确切概率 表 2 2组病人并发症情况比较(n)
眼轮匝肌预缝合缩短术在中老年睑袋整复中的应用
Application value of presuture shortening of orbicularis oculi muscle in blepharoplasty in middle and old aged patients
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摘要:
目的探讨眼轮匝肌预缝合缩短术在中老年睑袋整复中的效果。 方法将60例做睑袋整复治疗的中老年病人随机分为2组,每组30例,其中,接受传统经皮入路下睑袋整形术者为对照组,接受眼轮匝肌预缝合缩短术者为观察组。观察组在传统的睑袋整形术的基础上,游离眼轮匝肌,在距离外眦角约0.5 cm处作垂直于眼轮匝肌的设计线,沿垂线离断眼轮匝肌,在断端各缝合牵引丝线,预先将一侧断端缝合至另一断端深面,根据轮匝肌的张力,酌情调整缝合位置,当轮匝肌达到较好外形以及张力时,嘱病人睁眼向额部看,观察睑袋整复效果,切除重叠部分,断端精细缝合。最后对比和分析2种治疗方案的疗效差异。 结果术后1年,观察组病人满意度高于对照组(P < 0.01)。2组病人并发症差异均无统计学意义(P>0.05)。 结论应用眼轮匝肌预缝合缩短术,能够明显提高治疗效果及病人满意度,值得临床借鉴。 Abstract:ObjectiveTo investigate the application effects of presuture shortening of orbicularis oculi muscle in blepharoplasty in the middle and old aged patients. MethodsSixty middle and old aged patients with palpebral bags were randomly divided into the control group and observation group(30 cases each group).The control group was treated with traditional percutaneous lower eyelid blepharoplasty, and the observation group was treated with presuture shortening of orbicularis oculi muscle based on the traditional blepharoplasty.The orbicularis oculi muscle was separated, and the line perpendicular to the orbicularis oculi muscle at a distance of 0.5 cm from the outer canthal angle was designed, the orbicularis oculi muscle was cut off.The traction thread was sutured at the broken end, the one side broken end was sutured into the deep surface of the other end in advance, and the position of suture was adjusted according to the tension of orbicularis muscle.When the orbicularis muscle reached a better shape and tension, the patients were asked to open their eyes to the forehead for observing the effects of blepharoplasty.The overlapping part was excised, and the broken end was finely sutured.The curative effect between two schemes was compared and analyzed. ResultsAfter 1 year of operation, the satisfaction degree in observation group was higher than that in control group(P < 0.01).There was no statistical significance in complications between two groups(P>0.05). ConclusionsThe application of presuture shortening of orbicularis oculi muscle can significantly improve the treatment effect and satisfaction of patients, which is worthy of promotion. -
表 1 2组病人满意度情况比较(n)
分组 n 满意 基本满意 不满意 总满意率/% uc P 观察组 30 28 2 0 100.0 6.20 <0.01 对照组 30 19 7 4 86.7 合计 60 47 9 4 93.3 表 2 2组病人并发症情况比较(n)
分组 睑外翻 血肿 切口感染 1年后眼袋复发 1年后眶周皱纹复发 观察组 0 1 0 0 1 对照组 0 2 1 5 7 χ2 — 0.00 — 3.49 3.61 P — >0.05 >0.05* >0.05 >0.05 *示Fisher′s确切概率 -
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