三种手术治疗中重度上睑下垂的疗效比较

Comparison of the curative effect of three kinds of surgery for moderate to severe blepharoptosis

目的比较三种手术治疗中重度上睑下垂的临床效果。方法回顾性分析2017年1月-2019年1月于我院整形美容科接受治疗的105例中重度上睑下垂患者临床资料,将采用额肌筋膜悬吊术(FMFS)治疗的患者归为A组(36例),将采用传统提上睑肌缩短术(LS)治疗的患者归为B组(34例),将采用联合筋膜鞘(CFS)悬吊术治疗的患者归为C组(35例)。两组术后均随访6个月至1年。对比三组患者临床疗效与术前、术后1个月泪膜、角膜功能与术后并发症发生情况。结果 C组临床总有效率高于A、B组,差异有统计学意义(P<0.05);A组、B组临床总有效率比较,差异无统计学意义(P>0.05)。术后1个月,三组泪液分泌实验(SIt)结果较术前下降,角膜荧光染色(FL)评分水平较术前上升,而C组SIt结果、FL评分水平较A、B组低,B组SIt结果、FL评分较A组低,差异有统计学意义(P<0.05);C组并发症发生率较A组、B组低,差异有统计学意义(P<0.05)。结论中重度上睑下垂患者采用CFS悬吊术治疗效果显著,可提升临床疗效,改善患者的泪膜、角膜功能,且安全性较高,值得临床推广。

Objective To compare the clinical effects of three types of surgical treatments for moderate to severe blepharoptosis.Methods The clinical data of 105 patients with moderate to severe blepharoptosis who were treated in the Department of Ophthalmology of our hospital from January 2017 to January 2019 was retrospectively analyzed,and the patients treated with frontal myofascial suspension(FMFS)were classified as group A(36 cases),the patients treated with traditional levator palpebral muscle shortening(LS)were classified as group B(34 cases),and those treated with conjoint fascial sheath(CFS)suspension were classified as group C(35 example).Both groups were followed up for 3 months.The clinical efficacy,tear film and corneal function before and 1 month after operation,and postoperative complications of the three groups were compared.Results The total clinical effective rate of group C was higher than that of groups A and B,and the difference was statistically significant(P<0.05);compared the clinical total effective rate between group A and group B,the difference was not statistically significant(P>0.05).1 month after the operation,the results of the three groups of tear secretion test(SIt)were lower than those before the operation.the corneal fluorescence staining(FL)score was higher than before the operation,the SIt result and FL score of group C were lower than those of groups A and B,and the SIt result and FL score of group B were lower than those of group A,and the difference was statistically significant(P<0.05);the incidence of complications in group C was lower than that in groups A and B,and the difference was statistically significant(P<0.05).Conclusion The treatment effect of CFS suspension for moderate to severe blepharoptosis patients is significant,which can improve the clinical efficacy,improve the tear film and corneal function of the patients,and has high safety.It is worthy of clinical promotion.