高密度多孔聚乙烯下睑植片联合外侧睑板条悬吊术重建面瘫后眼睑闭合功能

发布时间：2018-01-29 07:23

本文关键词： 高密度多孔聚乙烯下睑植片外侧睑板条悬吊术面瘫眼睑闭合不全　出处：《中国修复重建外科杂志》2014年02期 　论文类型：期刊论文

【摘要】：目的探讨高密度多孔聚乙烯(Medpor)下睑植片联合外侧睑板条悬吊术重建面瘫后眼睑闭合功能的疗效。方法 2008年3月-2012年12月,收治32例(32眼)各种原因面瘫所致眼睑闭合不全。男20例,女12例;年龄20~72岁,平均46.8岁。左眼18例,右眼14例;病程1.5个月~2年,平均4.4个月。患者均合并不同程度下睑退缩、下睑外翻、暴露性角膜炎、角膜溃疡,上睑无明显退缩。采用高密度多孔Medpor下睑植片联合外侧睑板条悬吊术治疗。结果术后患眼切口均Ⅰ期愈合;眼睑浮肿5 d~3周,平均2周。4例于术后2周出现球结膜水肿,对症处理后消退。患者术后均获随访,随访时间5~8个月,平均6个月。术后1周、3个月、6个月睑裂高度、兔眼、下睑退缩量均较术前明显下降(P0.05);术后各时间点间比较,差异均无统计学意义(P0.05)。术后1个月3例下睑外眦移位,经重新行外侧下睑板条复位悬吊固定后治愈。随访期间均无下睑外翻及角膜暴露,无植片移位、外露。结论采用高密度多孔Medpor下睑植片联合外侧睑板条悬吊术可有效重建面瘫后眼睑闭合功能。
[Abstract]:Objective to evaluate the effect of blepharoplasty combined with lateral tarsal sling for reconstruction of eyelid closure after facial palsy. Methods from March 2008 to December 2012. Cases of eyelid insufficiency caused by facial palsy were treated in 32 cases (20 males and 12 females). The average age was 46.8 years old, with 18 cases with left eye and 14 cases with right eye. The course of disease ranged from 1.5 months to 2 years (mean 4.4 months). All the patients were complicated with lower eyelid retraction, ectropion, exposed keratitis and corneal ulcer. There was no obvious retraction of upper eyelid. High density porous Medpor lower eyelid graft combined with lateral tarsal sling was used. The blepharoedema occurred in 4 cases at 2 weeks after operation for 3 weeks (mean 2 weeks) and disappeared after treatment. All the patients were followed up for 5 ~ 8 months (mean 6 months) and 1 week after operation. After 3 months and 6 months, the height of eyelid fissure, the amount of rabbit eyes and lower eyelid retraction were significantly lower than those before operation (P 0.05). There was no significant difference between different time points after operation (P 0.05). One month after operation, 3 cases had lower eyelid lateral canthus displacement. After the lateral lower eyelid lath reduction and suspension fixation, no lower eyelid ectropion and corneal exposure, no graft displacement during the follow-up period. Conclusion High density porous Medpor lower eyelid graft combined with lateral tarsal sling can effectively reconstruct eyelid closure after facial paralysis.
【作者单位】：昆明医科大学第一附属医院眼科;昆明医科大学解剖学教研室;昆明医科大学第一附属医院神经外科;昆明医科大学第一附属医院耳鼻咽喉-头颈外科;
【基金】：云南省科技厅-昆明医科大学联合专项基金资助项目(2012FB037)~~
【分类号】：R779.6
【正文快照】： 面瘫后眼睑闭合不全不仅影响患者面部外观,还使眼球丧失了眼睑的保护作用,容易出现角膜暴露等一系列眼科并发症。此类疾病的治疗需兼顾眼睑闭合功能重建和外观修复,目前相关术式较多,但均存在一些不足。例如上睑金片、铂金植入术[1-3]存在体位限制,卧位时眼睑仍闭合不佳;提上

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