切缘上方眼轮匝

发布时间：2018-05-01 10:35

本文选题：眶隔 + 眼轮匝肌　；参考：《青岛大学》2017年博士论文

【摘要】：目的:探讨切缘上方的眼轮匝肌、眶隔固定于睑板前筋膜在上睑成形术中的临床应用及效果。方法:选取要求行重睑成形术的美容就医者150名,根据手术方式的不同分为A、B、C组,每组有50例。分别为改良重睑成形术术式组,传统重睑成形术术式组,和Park法重睑成形术术式组。其中A组美容就医者采用改良重睑成形术术式,将切缘上方的眼轮匝肌近睑板部分及眶隔膜底部下拉与睑板前筋膜固定。伴有上睑中度及重度肥厚者,直接将切口上方的眼轮匝肌与睑板前筋膜固定,不与眶隔底部缝合。B组美容就医者采用传统重睑成形术术式,单纯穿挂睑板固定缝合皮肤。C组美容就医者采用Park法重睑成形术术式将切缘下方的眼轮匝肌与上睑提肌腱膜内固定的双层缝合方式。术后6个月,每位患者完成一份问卷,主要从对手术效果的评价。手术效果包括双侧重睑线对称性、重睑线自然流畅性、重睑宽度、重睑沟深浅、皮肤肥厚程度。美容就医者在优、良、可、差4个级别中选择一项作为评价。通过Likert5点量表,美容就医者对每个方面的满意度进行评分,5=非常满意,4=满意,3=一般,2=不满意,1=非常不满意。美容就医者把自己的具体意见直接写在调查问卷上。比较各组患者满意度得分差异。应用SPSS 17.0统计软件,t检验分析各组之间患者年龄的差异;Mann-Whitney U检验分析各组间各项满意度差异,以P0.05为差异有统计学意义。结果:150名美容就医者均手术顺利。问卷调查显示:A组美容就医者对所有调查项目评价均较高,B组有3例美容就医者反映重睑线变浅。C组4例美容就医者认为术后切缘下方肥厚比较明显;1例美容就医者在拆线后出现双侧重睑的宽度轻度不对称,3个月后较前改善,6个月后基本满意。满意度统计显示:A组与B组之间对重睑沟深浅方面的差异有统计学意义(P0.05),A组与C组之间对重睑厚度方面的差异有统计学意义(P0.05)。结论:通过将切缘上方的眼轮匝肌近睑板部分及眶隔膜底部与睑板前筋膜固定的改良上睑成形术较传统重睑成形术及Park法临床效果良好,且持久保持。
[Abstract]:Objective: to investigate the clinical application and effect of orbicularis oculi muscle with orbital septum fixed on the prepalpebral fascia in upper eyelid plasty. Methods: 150 patients with double blepharoplasty were divided into two groups: group A (n = 50) and group C (n = 50). They were modified double blepharoplasty group, traditional double blepharoplasty group and Park double blepharoplasty group. Group A was treated with modified double blepharoplasty. The proximal tarsal plate of orbicularis oculi muscle and the orbital septum were pulled down and fixed with the anterior fascia of tarsal plate. In the patients with moderate or severe hypertrophy of upper eyelid, the orbicularis oculi muscle and the anterior fascia of the tarsal plate were fixed directly, without suture to the bottom of the orbital septum. Group B was treated with traditional double blepharoplasty. The double layer suture of orbicularis oculi muscle and upper eyelid levator tendon was performed by Park double eyelid plasty. 6 months after operation, each patient completed a questionnaire, mainly from the evaluation of the results of surgery. The results of operation include symmetry of double eyelid line, natural fluency of double eyelid line, width of double eyelid, depth of double eyelid sulcus and degree of skin hypertrophy. Beauty on the doctor in the excellent, good, fair, poor four levels of choice as an evaluation. According to the Likert5 scale, the cosmetic patients' satisfaction with each aspect was evaluated by 5 = very satisfactory 4 = satisfactory 3 = general 2 = unsatisfactory 1 = very unsatisfactory. Beauty on the doctor to write their own specific opinions directly on the questionnaire. The scores of patients' satisfaction were compared. Mann-Whitney U test was used to analyze the difference of patients' age in each group with SPSS 17.0 statistical software (t test). Results all the 150 cosmetologists were successfully operated on. The questionnaire survey showed that the evaluation of all the survey items in group A was higher than that in group B. There were 3 cases of cosmetic therapy in group B and 4 cases in group C reflecting shallowness of double eyelid line. 4 cases in group C thought that the hypertrophy below the incision margin was obvious in 1 case. The width of double eyelids was slightly asymmetrical, improved after 3 months, and satisfied after 6 months. The statistical results of satisfaction showed that there were significant differences in the depth and depth of double eyelid sulcus between group A and group B. There was significant difference in the thickness of double eyelid between group A and group C (P 0.05). Conclusion: the modified upper eyelid blepharoplasty with the proximal tarsal plate of orbicularis oculi muscle and the base of orbital septum and prepiric fascia is better than that of traditional double eyelid plasty and Park method.
【学位授予单位】：青岛大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R779.6;R62

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