Z成形术与改良Z成形术的内眦赘皮矫正疗效比较

Comparison of the clinical efficacy of Z-plasty and modified Z-plasty in the correction of epicanthus

目的比较Z成形术与改良Z成形术矫正内眦赘皮的效果。方法将152例行内眦赘皮矫正术同期行切开重睑成形术的患者随机分为A、B两组。A组行Z成形术,B组行改良Z成形术。术前根据患者内眦睑裂角度,A、B两组中内眦角较为尖锐(内眦睑裂角度<45°)者分别记为A1、B1组,内眦角较为圆钝(内眦睑裂角度>55°)者分别记为A2、B2组。根据患者睑裂长度和内眦间距比值(HLFL/ICD)、瘢痕增生、内眦赘皮回缩情况,及内眦睑裂角度(美学标准值为45°~55°),观察两组患者的术后效果,并行t检验和χ~2检验。结果术后随访3~18个月,两组患者的HLFL/ICD及术后6个月内眦赘皮回缩情况比较差异无统计学意义(P>0.05),A组瘢痕增生情况整体较B组严重,其差异存在统计学意义(P<0.05)。A1、B2组患者术后内眦睑裂角度更接近于标准值。结论两种内眦赘皮矫正方法各有优缺点,应根据患者内眦角的情况来选择合适的术式。Z成形术适合于内眦睑裂角度<45°者,改良Z成形术适合于内眦睑裂角度>55°者。

Objective To compare the clinical efficacy of Z-plasty and modified Z-plasty in the correction of epicanthus.Methods From July 2016 to January 2018,152 patients who underwent double blepharoplasty in our hospital were selected.All patients were randomly assigned to either group A or B.The Z-plasty was performed in group A and modified Z-plasty was performed in group B.According to the preoperative angles of the inner epicanthus,patients with sharp inner canthus angles（less than 45°） were marked as either A1 or B1 group,and obtuse inner canthus angles（more than 55°） were marked as either A2 or B2 group.Based on palpebral fissure length,the ratio of palpebral fissure length to inner canthal distance（HLFL/ICD）,scar hyperplasia,epicanthus retraction,and the palpebral fissure angle of the inner canthus（aesthetic standard ranged from 45° to 55°）,the postoperative effect in the A and B groups was observed and a T-test and chi-square test was performed.Results All patients were followed up from 3 to 18 months,the difference in HLFL/ICD and epicanthus retraction at postoperative 6 months between the two groups had no statistical significance（P0.05）.The scar hyperplasia of group A was higher than that of group B.The differences had statistical significance（P0.05）.The postoperative palpebral fissure angle of the inner canthus in group A1 and B2 was closer to the standard value.Conclusion These two methods have different advantages and disadvantages.The appropriate operation method should be selected according to the angles of the patients′ inner canthus.Z-plasty was suitable for patients whose inner canthus angles was less than 45°,and modified Z-plasty was suitable for inner canthus angles more than 55°.