联合筋膜鞘悬吊术与额肌瓣悬吊术矫正重度上睑下垂的临床效果

Clinical effects of combined fascia sheath suspension and frontal muscle flap suspension in correction of severe congenital ptosis

目的 对比联合筋膜鞘悬吊术与额肌瓣悬吊术在治疗先天性重度上睑下垂的疗效差异.方法 选取先天性重度上睑下垂患者46例58只眼,分为联合筋膜鞘悬吊术组与额肌瓣悬吊术组;比较两组术后睑裂高度,睑缘弧度,闭眼后角膜暴露程度,眼睑活动度,并发症出现的情况;并调查患者满意度.结果 联合筋膜鞘悬吊术组矫正有效率、并发症发生率和患者满意度分别为93.10％,6.9％,（91.22±0.37）分,额肌瓣悬吊术组分别为75.86％,24.14％,（75.05±0.28）分,差异均有统计学意义（P＜0.05）.结论 联合筋膜鞘悬吊术对于先天性重度上睑下垂效果显著,并发症少,患者具有更高满意度,值得临床推广.

Objective To compare the therapeutic effect of combined fascia sheath suspension and frontal muscle flap suspension in the treatment of congenital severe congenital ptosis.Methods 46 cases （58 eyes） with congenital severe upper eyelid prolapse who were treated from March 2015 to March 2016 in Eye Hospital of Hebei Province were selected.The patients were divided into two groups：combined fascial sheath suspension group and frontalis muscle flap suspension.Comparisons of postoperative patients with eyelid height,eyelid radian,corneal exposure with eyes closed,eyelid activity,complication of the situation were carried out.And patient satisfaction survey was conducted.Results The effective rate of combined fascial sheath suspension group was 93.10%,the complication rate was 6.9%,and the patient satisfaction rate was 91.22±0.37,significantly better than the frontal muscle flap suspension group of patients （75.86 %,24.14 % and 75.05 ± 0.28,respectively）.The time of closure of the eyelid was shortened,the complications were less,and the eyelid had better activity.The difference between the two groups was statistically significant （P〈0.05）.Conclusions Combined fascia sheath for congenital severe upper eyelid droop is significant,with fewer complications and a higher rate of satisfaction,which is worth clinical promotion.