眉下缘切口去皮联合眉脂肪垫与传统去皮重睑术治疗中老年上睑松弛的效果比较

Comparison of the effects of superciliary lower ridge incision decortication combined with brow fat pad and traditional double eyelid shaping surgery in the treatment of upper eyelid relaxation in middle-aged and elderly patients

目的比较眉下缘切口去皮联合眉脂肪垫与传统去皮重睑术治疗中老年上睑松弛的效果。方法选取2015年3月至2018年3月在我院就诊的中老年上睑松弛患者86例,根据随机数表法将其分为对照组(传统去皮重睑术)和观察组(眉下缘切口去皮联合眉脂肪垫),各43例。比较两组的治疗效果。结果观察组的手术效果满意度高于对照组(P<0.05)。两组并发症总发生率无显著差异(P>0.05)。经典型病例分析,中度上睑区松弛患者经去皮重睑术治疗后,术后重睑线基本对称,眉眼部协调统一,倒睫症状改善,视野增宽;重度上睑区松弛患者经眉下缘切口去皮联合眉脂肪垫治疗后,重睑线明显增宽,"三角眼"外观消失,眼周皱纹明显减少。结论传统去皮重睑术和眉下缘切口去皮联合眉脂肪垫治疗均可在一定程度上改善中老年患者上睑松弛症状,但眉下缘切口去皮联合眉脂肪垫治疗可更好地矫正鱼尾纹和上睑松弛,特别是重症上睑松弛,恢复患者上睑和眉区的外观,提高手术效果满意度。

Objective To compare the effects of superciliary lower ridge incision decortication combined with brow fat pad and traditional double eyelid shaping surgery in the treatment of upper eyelid relaxation in middle-aged and elderly patients. Methods Eighty-six middle-aged and elderly patients with upper eyelid relaxation who were treated in our hospital from March 2015 to March 2018 were divided into control group (traditional double eyelid shaping surgery) and observation group (superciliary lower ridge incision decortication combined with brow fat pad) according to the random number table method, with 43 cases in each group. The therapeutic effects of the two groups were compared. Results The satisfaction degree with surgical effects of the observation group was higher than that of the control group (P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05). According to the typical case analysis, as for patients with moderate upper eyelid relaxation after the treatment of double eyelid shaping surgery, the postoperative double eyelids line was basically symmetrical, the eyebrows and eyes were in harmony, the symptom of trichiasis improved, and the visual field was widened;as for patients with severe upper eyelid relaxation after the treatment of superciliary lower ridge incision decortication combined with brow fat pad, the double eyelids line was widened, the appearance of "triangular eye" disappeared, and the wrinkles around the eyes significantly reduced. Conclusion Traditional double eyelid shaping surgery and superciliary lower ridge incision decortication combined with brow fat pad can improve the symptoms of middle-aged and elderly patients with upper eyelid relaxation to a certain extent. However, superciliary lower ridge incision decortication combined with brow fat pad can better correct the crow's feet and eyelid relaxation, especially for severe upper eyelid relaxation, which can restore the appearance of upper eyelid and eyebrow area, and improve the satisfaction of surgical effects.