中央小切口微创重睑术与内中外小切口重睑术的前瞻性对照研究

Prospective and comparative study of the double eyelid blepharoplasty with central minimal incision and with three minimal incisions

目的 评价中央小切口微创重睑术与内中外小切口重睑术的临床效果.方法 选择2010年7月至2012年5月在福建医科大学附属协和医院整形外科接受双侧重睑手术患者作为研究对象,根据随机数字表将其分为A、B两组,其中A组268例采用中央小切口微创重睑术,B组102例采用内中外小切口重睑术.记录每例手术耗时、术后消肿恢复时间、有无明显淤青或血肿、重睑变浅或消失的比例及瘢痕增生、术后效果及患者满意度评价,并于术前、术后即刻、1、2、4、8、12周时分别拍照、记录.分别用Wilcoxon秩和检验分析2组手术时间、消肿恢复时间,用卡方检验分析2组重睑变浅或消失、术后瘢痕满意程度,用t检验分析2组患者满意度综合评分是否有统计学差异.结果 A组手术时间为（25.63±3.74） min,短于B组的（29.90-±4.13） min（Z=-8.011,P＜0.01）;A组术后最早1周开始消肿,最晚4周,消肿速度快于B组（Z=-15.887,P＜0.01）;术后淤青发生率为1.49％,低于B组的7.84％ （P ＜0.05）,且无重睑变浅、消失病例,患者对术后瘢痕均表示满意.A组患者综合满意度评价得分为（97.302±1.764）分,优于B组的（88.628±10.880）分（t=12.650,P＜0.05）.结论 中央小切口微创重睑术具有手术简单易行、效果自然确切、术后恢复较快、并发症相对较小、易于学习等优点,适用于除上睑皮肤松弛外的所有单睑者。

Objective To compare the clinical effect of the double eyelid blepharoplasty with central minimal incision and with three minimal incisions.Methods From Jul.2010 to May 2012,268 cases （Group A） received double eyelid blepharoplasty with central minimal incision,while 102 cases （Group B） underwent double eyelid blepharoplasty with three minimal incisions.Photos were taken immediately,and 1,2,4,8,12 weeks after operation.Operation time,recovery time and postoperative complications were evaluated and recorded.The operation time and recovery time were analyzed by Wilcoxon rank sum test.The postoperative complications were analyzed by chi square test.The satisfactory degree was analyzed by t test.Results The operation time in Group A was （25.63-± 3.74） min,compared with that （29.90 ±4.13） min in Group B （Z =-8.011,P 〈0.01）.Meanwhile,the recovery time in Group A was shorter than that in Group B （Z=-15.887,P〈0.01）.The occurrence rate of postoperative complications,including hematoma,recurrence and scar hyperplasia in Group A was also lower than that in Group B.At the same time,the satisfactory degree in Group A was（97.302-± 1.764）,which was higher than that（88.628 ±-10.880） in Group B （t=12.650,P〈0.05）.Conclusions The double eyelid blepharoplasty with central minimal incision,which is suitable for all cases except those who has serious blepharochalsais,has more advantages than double eyelid blepharoplasty with three minimalincisions.