上睑老化的综合手术治疗

发布时间：2018-08-11 20:16

【摘要】： 目的：随着年龄的增长,面部衰老最早表现为上睑老化征象：皮肤松弛,出现皱褶,外眦下垂,严重者影响视野；额肌松弛,眉下垂；部分由于眶隔筋膜松弛,眶脂脱出,上睑呈现臃肿,部分眶脂萎缩,上睑凹陷；部分出现不同程度上睑下垂。通过对中老年上睑老化表现和解剖学变化的整体研究,探讨一种针对中老年上睑老化的较简单、损伤小且一次性改善上睑周围老化状态的手术方法。方法：门诊手术病例84例,均为女性,年龄40-80岁,上睑均存在不同程度老化外观。针对眉形好且原有重睑线者采用眉缘切口,根据眉与睑缘间距采用眉上、下缘不同切口；针对眉形不佳者采用眉部切口,切除部分眉毛；针对患者单睑有重睑要求者行重睑切口；针对上睑松弛严重者行睑缘切口；对眉下垂且有重睑要求者行提切眉联合重睑切口；术中针对不同情况切除多余的皮肤、脂肪和松弛的眼轮匝肌等。针对老年性上睑凹陷,采用眉缘切口额肌筋膜瓣折叠转移的方法,填充凹陷。针对老年性上睑下垂,采用眉缘切口额肌筋膜-上睑提肌腱膜复合瓣折叠悬吊的方法。结果：门诊84例病人均实施了上睑年轻化手术,从而矫正了眉下垂、上睑松弛、上睑凹陷及老年性上睑下垂等多个上睑老化表现。术后重睑及眉形自然,瘢痕不明显,上睑老化现象得以纠正。结论：对于上睑老化者,采用多元切口及额肌筋膜瓣、额肌筋膜-上睑提肌腱膜复合瓣整复的手术方法可最大限度地改善上睑松弛,纠正老年性上睑凹陷及老年性上睑下垂。此方法操作简单,对组织损伤小,使功能得到改善并达到持久的眼睑美化、年轻化。患者易于接受,效果好。
[Abstract]:Objective: with the increase of age, the first sign of facial aging is upper eyelid aging: skin flabby, wrinkle, lateral canthus drooping, serious affecting visual field; frontal muscle relaxation, eyebrow prolapse; orbital fat prolapse due partly to orbital septal fascia relaxation. The upper eyelid is bloated, some orbital fat atrophy, upper eyelid depression, and some blepharoptosis. Based on the overall study of the aging appearance and anatomical changes of upper eyelid in middle and old age, this paper discusses a simple method for the aging of upper eyelid in middle and old age, which has less damage and improves the aging state of upper eyelid around the upper eyelid at one time. Methods: 84 cases of outpatient operation were all female, aged 40-80 years. For those with good eyebrow shape and original double eyelid line, eyebrow margin incision was adopted, according to the distance between eyebrow and eyelid margin, different incision was adopted in lower margin, and eyebrow incision was used to remove part of eyebrow for those with poor eyebrow shape. Double eyelid incision for patients with single eyelid with double eyelid requirement; eyelid margin incision for severe upper eyelid relaxation; lifting eyebrow incision combined with double eyelid incision for those with lower eyebrow and double eyelid; excision of redundant skin according to different conditions, Fat and loose orbicularis oculi muscle, etc. For the senile upper eyelid depression, the forehead fascia flap was folded and transferred through the brow margin incision to fill the depression. In view of senile ptosis, the frontalis fascia and upper eyelid levator tendon composite flap was used to fold and suspend the upper eyelid levator tendon flap. Results: 84 cases of outpatients underwent upper eyelid rejuvenation operation, which corrected many signs of upper eyelid aging, such as eyebrow ptosis, upper eyelid relaxation, upper eyelid depression and senile blepharoptosis. After operation double eyelid and eyebrow shape are natural, scar is not obvious, upper eyelid aging phenomenon can be corrected. Conclusion: for the aged upper eyelid, multiple incision and frontalis fascia flap, frontalis fascia and upper eyelid levator tendon composite flap can greatly improve the upper eyelid relaxation and correct the senile upper eyelid depression and senile ptosis. This method is easy to operate, has less tissue damage, improves the function and achieves lasting eyelid beautification and rejuvenation. The patient is easy to accept and the effect is good.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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