上睑下垂225例手术治疗临床观察
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Clinical observation of surgical treatment of ptosis in 225 cases
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    摘要:

    目的:观察治疗上睑下垂的各种术式的疗效及优缺点,为临床选择合理手术方法提供理论依据。

    方法:回顾性分析我院2008-01/2011-12间225例298眼已施行上睑下垂手术的患者,按照不同的手术方式分为两组:借用额肌力量的手术和提上睑肌复合体的手术。对患者行3~6mo的术后随访观察,进行疗效评价与分析。

    结果:全部患者分成两组,借用额肌力量的手术患者38例44眼,其中2眼过矫,1眼复发,治愈率93.2%; 提上睑肌复合体的手术患者187例254眼,其中4眼过矫,2眼欠矫,治愈率97.6%,明显高于借用额肌力量手术组。2例2眼上睑下垂手术后短期欠矫患者,重新打开切口上调提上睑肌固定位置; 1例1眼上睑下垂6mo后复发,再次手术发现缝线脱落给予修复; 4例6眼过矫给予松解额肌或提上睑肌调整睑缘位置,均改善了上睑下垂症状和达到了容貌改观。

    结论:先天性上睑下垂原则上应及早矫治,早手术可防止儿童弱视和心理障碍。后天性上睑下垂病因多样,应根据不同病因进行治疗,待病情稳定3~6mo后根据受术者的病情程度选择不同的上睑下垂矫正术,以提高疗效,并减少并发症。

    Abstract:

    AIM:To observe the advantages and disadvantages of different surgeries for the treatment of ptosis to provide theory and basis for clinical choice of reasonable operation method.

    METHODS:A retrospective analysis of 225 cases 298 eyes performed ptosis operation in our hospital from January 2008-December 2011. According to the different operation modes patients were divided into two groups: borrow frontalis muscle power operation, as well as the levator palpebrae superioris complex operation. Patients were performed 3-6 months' follow-up observation, evaluation and analysis. The effects of two groups were compared.

    RESULTS: All of the patients divided into two groups, borrowed from the frontal muscle power operation in 38 cases 44 eyes,2 eyes overcorrection, 1 case of recurrence, the cure rate was 93.2%; levator palpebrae superioris complex operation in 187 cases 254 eyes,6 eyes and 2 eyes overcorrection, undercorrection, the cure rate was 97.6%, significantly higher than the amount of muscle strength in use operation group 2 cases 2 eyes with ptosis after operation of short-term undercorrection, reopened incision and upregulated the levator palpebrae superioris muscle fixed position; 1 case 1 eye recurred after half year, the re-operation found suture exfoliated then repaired; 4 cases 6 eyes of overcorrection released upper eyelid muscle to adjust the margin position. All surgeries have improved the blepharoptosis symptoms and reached the appearance change.

    CONCLUSION:Congenital ptosis in principle should be treated early, earlier operation can prevent children from amblyopia and mental disorders. Acquired ptosis due to a variety of causes, which should be treated according to the different causes first, then in stable condition 3-6 months after choose different operation methods. Correction of ptosis based on the severity, select the appropriate operation, improve the curative effect to reduce complications.

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南银娟,欧阳红专.上睑下垂225例手术治疗临床观察.国际眼科杂志, 2012,12(12):2376-2378.

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  • 收稿日期:2012-05-22
  • 最后修改日期:2012-11-15
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