应用颞浅血管蒂组织皮瓣修复下眼睑缺损

Application of pedicled flap with superficial temporal vessel in reconstruction of inferior eyelids defects

目的探讨颞浅血管蒂组织皮瓣在修复下眼睑缺损中的临床应用价值。方法2004年6月至2007年10月对本院8例下眼睑缺损患者行带有颞浅血管蒂组织皮瓣修复缺损，分别于术前和术后2周行泪膜破裂时间（BUT）、泪液分泌量、角膜荧光素染色测量和比较。并术后随访。结果术后皮瓣全部成活，皮瓣与眼睑皮肤颜色、质地和外形相近。患者术后BUT[（9．50±2．61）S]较术前[（4．35±2．46）s]延长；术后泪液分泌量[（10．86±．40）mm]较术前[（4．50±1．78）mm]明显增多，均P〈0．05。术后角膜荧光素染色点明显减少（均P〈0．05）。8例患者眼睑外观和功能明显改善，临床效果满意。结论颞浅血管蒂组织皮瓣安全可靠，易于操作，带有颞浅血管蒂的皮瓣转位是一种较为理想的修复下眼睑缺损的方法。

Objective To investigate the clinical application of pedicled flap with superficial temporal vessel in reconstruction of inferior eyelids defects. Methods Eight cases of inferior eyelids defect were reconstructed using pedicled flap with superficial temporal vessel from June 2004 to October 2007 in our hospital, and all the patients were followed up. The tear fihn breakup time, lacrimal secretion （Schirmer I test） and cornea fluorescent pigmentation examination before and after surgery were examined. Results After the reconstruction, all the skin flaps were completely survived with satisfactory color, quality and contour close to skin of the eyelids. There were significant differences in the tear film breakup time [ （4.35± 2.46） s vs （9.50±2.61） s] , lacrimal secretion [（4.50±1.78）mm vs （10.86±3.40） mm] before and after surgery （all P〈0.05）. Cornea fluorescent pigmentosa decreased obviously after surgery, all P〈0.05. The shape and function of inferior eyelids in 8 cases were improved obviously, and clinical outcome was satisfactory. Conclusion Reconstruction of inferior eyelids defect using pedicled flap with superficial temporal vessel is an ideal approach which is safe and easy to manipulate.