过睑板下缘连续缝合内固定联合眶隔整复治疗下睑赘皮的疗效观察

Effects of over the lower edge of the tarsal joint continuous suture fixation combined with orbital entire complex on eyelid epicanthus

目的 探讨过睑板下缘连续缝合内固定联合眶隔整复治疗下睑赘皮的疗效.方法 选取50例（100眼）下睑赘皮患者的临床资料.按照数字编号法,将其随机均分为对照组与观察组,各为50眼.对照组给予过睑板下缘连续缝合内固定术治疗,观察组在此基础上联合眶隔整复治疗.比较两组治疗疗效、疼痛情况、治疗前后下睑皮各测量指标及并发症发生情况等.结果 治疗后,对照组下睑赘皮矫正、睫毛接触角膜及角膜上皮损害愈合眼数分别为39眼（78.00％）、10眼（20.00％）及43眼（86.00％）,观察组分别为49眼（98.00％）、1眼（2.00％）及50眼（100.00％）,两组差异均有统计学意义（x2=5.559、16.839、3.273,P＜0.05,P＜0.01）;根据VAS疼痛评分标准,两组治疗前后VAS评分差异均有统计学意义（t=5.271、12.593,P＜0.05,P＜0.01）,且观察组治疗后VAS得分与对照组治疗后相比,差异具有统计学意义（t=4.399,P＜0.05）;两组治疗前后皱襞距睑缘距离、平视下睑缘距瞳孔位置、平视下睑皮缘位于睑缘、平视睫毛倾斜度、内眦角度、外眦角度、内眦皱襞、睑裂高度、平视上下泪小点间距、眼轮匝肌睑部宽度、眼轮匝肌睑部厚度及眼轮匝肌眶部厚度等方面的差异均具有统计学意义,且观察组治疗后上述指标与对照组治疗后相比,差异均有统计学意义（t=4.292、5.828、4.135、5.099、4.723、5.002、6.717、8.092、7.038、8.056、3.129、7.043,均P＜0.05）;两组治疗过程中均会出现下睑退缩、睑外翻及眼睑瘢痕等并发症,对照组并发症发生率为20.00％,明显大于观察组（6.00％）,两组相比,差异有统计学意义（x2=13.283,P＜0.01）.结论 过睑板下缘连续缝合内固定联合眶隔整复治疗下睑赘皮的疗效显著,并发症发生率低,值得在临床上加以推广并应用.

Objective To investigate the continuous suture through the lower edge of the tarsal joint fixation orbital reconstructive eyelid superfluous skin treatment efficacy.Methods 50 cases of abject epicanthus clinical data were retrospectively analyzed from June 2009 to June 2013 in our hospital by the hospital ethics committee approved,which had a total of 100 eyes.According to the numbering method,they were randomly divided into control group and observation group,each 50 cases.Control group was given through the lower edge of the tarsal continuous suture fixation,while the observation group was treated on the basis of control group combined with joint orbital entire complex treatment.Therapeutic effects were compared,pain,treatment before and after each measurement indicators and lower eyelid skin complications and so on.Results After treatment,the control group redundant lower eyelid skin correction,eyelash contact with the cornea and corneal epithelial healing of eye damage were respectively 39 （78.00%）,10 （20.00%） and 43 （86.00%）,while the observation group were 49 （98.00%）,1 （2.00%） and 50 （100.00%）,the above parameters were statistically significant differences （x2 =5.559,16.839,3.840,P 〈 0.05,P 〈 0.01） ; According to VAS pain score,VAS scores before and after treatment were statistically significant （t =5.271,12.593,P 〈0.05,P 〈 0.01）,and the observation group after treatment VAS scores after treatment compared with the control group,the difference was statistically significant（t =4.399,P 〈 0.05） ; Before and after treatment from the eyelid folds distance,flat as the lower eyelid away from the eye position,head lower eyelid skin flap in eyelid,head tilt eyelashes,inner canthal angle,outer canthal angle,inner canthal folds,palpebral fissure height,head of small tears on the pitch,orbicularis muscle eyelid width,eyelid orbicularis muscle thickness and orbital orbicularis muscle thickness differences were statistically significant,and the observation group after treatment with these indicators compared to the control group after treatment,the differences were statistically significant （t =4.292,5.828,4.135,5.099,4.723,5.002,6.717,8.092,7.038,8.056,3.129,7.043,P 〈 0.05） ; the course of treatment in both groups would be lower eyelid retraction,ectropion and eyelid scar concurrent disease control group complication rate was 20.00%,which was significantly higher than that of the observation group（6.00%）,the difference was significant statistical significance（x2 =13.283,P 〈 0.01）.Conclusion Over the lower edge of the tarsal joint continuous suture fixation treatment of orbital reconstructive eyelid superfluous skin effect is significant,with low complication rate,which is worth to be promoted in clinical and applied.