提上睑肌缩短术与额肌瓣悬吊术治疗重度上睑下垂的临床比较

Clinical comparison of levator shortening and frontal muscle flap suspension for severe blepharoptosis

目的比较提上睑肌缩短术与额肌瓣悬吊术治疗重度上睑下垂患者的临床效果。方法选取我院62例重度上睑下垂患者,按照手术方法分组,各31例。缩短组行提上睑肌缩短术,悬吊组行额肌瓣悬吊术。对比两组手术时间、愈合情况、术后3个月矫正率、治疗满意度、并发症发生率、术前、术后3个月泪膜破裂时间、泪液分泌试验、角膜荧光染色检查结果。结果缩短组手术时间短于对照组(P<0.05);缩短组术后3个月矫正率92.68%(38/41)与悬吊组的87.50%(35/40)对比,差异无统计学意义(P>0.05);缩短组术后3个月治疗满意度90.24%(37/41)高于悬吊组72.50%(29/40)(P<0.05);术前、术后3个月两组泪膜破裂时间、泪液分泌试验、角膜荧光染色检查结果对比,差异无统计学意义(P>0.05);缩短组术后3个月并发症发生率12.20%(5/41)低于悬吊组30.00%(12/40)(P<0.05)。结论提上睑肌缩短术与额肌瓣悬吊术均可有效治疗重度上睑下垂,矫正效果相当,但提上睑肌缩短术治疗满意度高,并发症少,具有较高的安全性。

Objective The clinical effects of levator levator contraction and frontal muscle flap suspension on patients with severe ptosis were compared.Methods 62 patients with severe ptosis were enrolled in our hospital.All patients were divided into 31 cases according to the surgical method.The shortening group was performed with the upper diaphragm shortening,and the suspension group was performed with the frontal muscle flap suspension.The operation time,healing status,correction rate at 3 months after surgery,treatment satisfaction,incidence of complications,tear film rupture time before,3 months after surgery,tear secretion test,and corneal fluorescence staining were compared between the two groups.Results The operation time in the shortened group was shorter than expected(P<0.05);The correction rate of the shortened group was 92.68%(38/41)at 3 months after operation and 87.50%(35/40)in the suspension group.The difference was not statistically significant(P>0.05).The shortened group was treated 3 months after operation.Satisfaction 90.24%(37/41)was higher than suspension group 72.50%(29/40)(P<0.05);tear film rupture time,tear secretion test,corneal fluorescence staining test before and 3 months after operation Results were not statistically significant(P>0.05).The incidence of complications in the shortened group was 12.20%(5/41)at 3 months after operation(3/40%)(P<0.05).Conclusion Both the levator palpebral shortening and the frontal muscle flap suspension can effectively treat severe ptosis,and the correction effect is equivalent.However,the treatment of levator palpebral shortening has high satisfaction,less complications and high safety.