上睑提肌缩短术治疗不同年龄不同肌力的重度先天性上睑下垂的疗效观察

Shortening of levator muscle for patients with severe congenital blepharoptosis in different ages and different muscle strength

目的探讨上睑提肌缩短术对于不同年龄、不同肌力的重症上睑下垂的远期治疗效果。方法观察2008年1月至2009年8月在我院进行治疗的重症上睑下垂32例（40眼）术后1年的效果，所有患者均采用上睑提肌缩短术治疗，手术效果分为良好、尚好、差及过矫4级。所有患者按年龄分为两组（0—5岁组及6—25岁组），并且按上睑提肌肌力又分为两组（〈2mm，32mm）。结果不同年龄组之间比较：达I级疗效的，两组差异有统计学意义（P〈0．05）；不同肌力组之间进行比较：达I级疗效的，两组差异有统计学意义（P〈0．05）。结论对于重度先天性上睑下垂，只要不影响视功能，可等待至6岁以后采用上睑提肌缩短术治疗，对肌力≥2mm者的疗效优于肌力〈2mm者。上睑提肌缩短术治疗重度先天性上睑下垂。

Objective To observe the surgery effect of shortening of levator muscle for patients of severe congenital blepharoptosis in different ages and different muscle strength. Methods There were 32 cases （40 eyes） of severe congenital blepharoptosis from Jan. 2008 to Aug. 2009. All of them had undergone shortening of levator muscle. The effects one year after surgery were divided into good, still good, bad and o- ver correction. All patients were divided into 2 groups by age （0 - 5 years, 6 - 25 years）, and into 2 groups by levator muscle strength （ 〈 2 mm, ≥2 mm）. Comparison between different age groups and differ- ent muscle strength groups byx2 test. Results There was significant difference between 0-5 year-old group and 6-25 year-old group （ P 〈 0.05 ）. There was significant difference between different muscle strength groups （P 〈 0. 05 ）. Conclusion Patients with severe congenital blepharoptosis shoud be treated with sur- gery of shortening of levator muscle of upper lid after 6 years old, as long as visual function is normal. Effect of shortening of levator muscle surgery is better for patients of severe congenital blepharoptosis whose muscle strength ≥2 mm.