外伤性眼睑畸形的整复治疗(附68例报告)

Repair and reconstruction of traumatic eyelids deformities: A report of 68 cases

目的探讨各类外伤性眼睑畸形的合理整复方法。方法回顾性分析2002年6月-2011年6月解放军总医院第一附属医院收治的各类外伤性眼睑畸形68例,共计157个眼睑,其中包括睑外翻、眼睑部分或全部缺损、内眦瘢痕挛缩、眼睑粘连、眼周瘢痕等,采用急诊清创植皮、局部皮瓣(或瘢痕瓣)转移、眼轮匝肌皮瓣转移、软组织扩张术、睑板重建、额肌瓣转移、眦韧带悬吊等手术方法进行整复。结果 68例外伤性眼睑畸形外观及功能均明显改善,眼睑正常解剖结构基本得到恢复。结论针对不同致伤原因、损伤程度、周围情况、伤后时间选择合适的手术方法,尽早恢复眼睑的解剖学结构,是外伤性眼睑畸形整复的关键。

Objective To explore the plastic and reconstructive methods of traumatic eyelids deformities.Methods Data of 68 cases of traumatic eyelids deformities（157 eyelids）,collected by the First Affiliated Hospital of General Hospital of PLA from June 2002 to June 2011,were retrospectively analyzed,including eyelid ectropion,defect of partial or overall eyelid,cicatrix contraction of inner canthus,eyelid adherence and perioptic cicatices,etc.Restitution was done by debridement with skin grafting,transfer of local skin flaps,transfer of orbicularis muscle flaps,soft-tissue expansion,reconstruction of tarsal plates,transfer of frontalis flaps and canthus ligament suspension.Results All the eyelids deformities were repaired successfully.The functions and configurations were satisfactory after six months to eight years follow-up.Conclusion Traumatic eyelid deformity should be repaired as early as possible by appropriate methods according to the cause,type and range of the injury and local conditions.