结膜入路睑袋整复术中眶隔脂肪不同移植方法的临床效果对比

Comparison of clinical efficacy of different transplantation methods of orbital septum fat in lower eyelid pouch blepharoplasty through conjunctival approach

目的比较结膜入路睑袋整复术中,眶隔脂肪带蒂移植与游离移植矫正泪沟凹陷畸形的临床疗效。方法回顾性分析下睑皮肤无明显松弛,经Hirmand法分型为Ⅰ、Ⅱ型的睑袋伴泪沟畸形98例患者的临床资料,根据手术方法分为观察组和对照组,每组49例。观察组行结膜入路睑袋整复术,术中眶隔脂肪释放,带蒂移植矫正泪沟凹陷;对照组行结膜入路睑袋整复术,术中眶隔脂肪游离移植矫正泪沟凹陷。比较两组术后1、6个月泪沟畸形等级量表评分,术后并发症发生情况及患者满意度。结果98例患者均获随访6个月以上。术后1个月两组患者泪沟畸形等级量表评分比较,其差异无统计学意义(P>0.05);术后6个月两组患者泪沟畸形等级量表评分对比,其差异具有统计学意义(P<0.05)。两组术后并发症发生情况差异无统计学意义(P>0.05)。观察组患者满意度(95.92%)高于对照组(81.63%),其差异具有统计学意义(P<0.05)。结论在结膜入路睑袋整复术中,眶隔脂肪释放带蒂移植手术效果较好,术后患者满意度较高,值得临床推广应用。

Objective In the lower eyelid pouch blepharoplasty through conjunctival approach,the clinical efficacy of pedicled and free transplantation of orbital septum fat in the correction of tear trough depression deformity was compared.Methods The clinical data of 98 patients with lower eyelid pouch and tear trough deformity were analyzed retrospectively.The lower eyelid pouch was classified as type I and II by Hirmand method.According to the operation method,all patients were divided into the observation group(n=49)and control group(n=49).The lower eyelid pouch blepharoplasty through conjunctival approach was performed in both observation and control group.The pedicled transplantation of orbital septum fat was performed for the correction of tear trough depression during the operation.The free transplantation of orbital septum fat was performed for the correction of tear trough depression.The TTRS scores,complications and patients’satisfaction at 1 and 6 months after operation between 2 groups were compared.Results All patients were followed up for more than 6 months.There was no statistically significant difference in TTRS score at 1 month after operation between 2 groups(P>0.05).Six months after the operation,the TTRS scores between 2 groups were compared and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications(P>0.05).The percentage of satisfaction in the observation group(95.92%)was higher than that in the control group(81.63%),and the difference was statistically significant(P<0.05).Conclusion In the lower eyelid pouch blepharoplasty through conjunctival approach,the pedicled transplantation of orbital septum fat release had good curative effect and postoperative satisfaction.It should be considerable for clinical popularization and application.