全麻下小儿上睑下垂手术量化的临床观察

Clinical observation of operative quantization for congenital ptosis in children under general anesthesia

目的探讨在手术标记线引导下的全麻小儿上睑下垂手术量化的临床疗效及影响疗效的因素。方法依照术前所测得有关数据做手术标记线对56例63眼确诊为重度先天性上睑下垂的小儿全麻下实施改良额肌瓣悬吊术,依据提上睑肌肌力、额肌力的大小,同时结合全身麻醉的深度及眼位情况对术中的睑裂高度进行计算,从而来量化手术,记录并分析其临床资料,进行疗效评估。结果 56例63眼患儿中矫正满意者59眼(93.65%),欠矫者2眼(3.17%),过矫者2眼(3.17%)。术后半年发生回退者4眼(6.35%)。术后未出现感染、暴露性角膜炎等并发症。结论在手术标记线引导下并进行量化处理的全麻下小儿上睑下垂手术疗效较好。

Objective To discuss the clinical effect and its influence factors of operative quantization for congenital ptosis in children under general anesthesia with operative labeling line. Methods According to relevant data measured before opera- tion,the operative labeling line was made in 55 children （53 eyes） with severe congeni- tal ptosis to perform the modified frontal muscle flap suspension surgery under general anesthesia. According to the strength of levator palpebrae superioris and frontal muscle, combined with the degree of general anesthesia and situation of eyeball position, the height of intraoperative palpebral fissure was calculated to quantify the surgery. The clinical data was recorded and analyzed, and the curative effect was evaluated. Results In 53 eyes, the rectification was satisfied in 59 eyes （93.55%）, undercorrected in 2 eyes （3.17%） ,and overcorrected in 2 eyes （3.17%）. The regression in half of one year appeared in 4 eyes （ 5.35% ）. There was no complication, such as infection, exposure keratitis, et al. Conclusion The effects of operative quantization for congenital ptosis in children under general anesthesia with operative labeling line are well.