力学优先原则在切开法重睑成形术的应用研究

The clinical application of the principle of mechanics in the incision double blepharoplasty

目的探讨力学优先原则在切开法重睑成形术的临床应用。方法2017年1月至2020年1月,南京医科大学友谊整形外科医院整形美容外科就诊初次眼整形女性患者96例(年龄18~42岁,平均26岁)的双侧单睑患者行切开法重睑成形术。对合并内眦赘皮者行改良Park法内眦赘皮矫正术;对存在轻度上睑下垂者行提肌腱膜松解或提肌腱膜折叠术。通过手术进行松解粘连、组织复位、减轻负荷、加强提睑板力量等方法,减弱影响重睑皱褶形成的力学因素。结果96例患者上睑形态及皮肤松弛情况有明显改善。其中2例因术后重睑线弧度欠佳,1例因去皮量不足重睑较窄,2例因双侧不对称。其余患者睁闭眼位上下睑形态较自然,切口瘢痕不明显,效果满意。结论采用力学优先原则行切开法重睑成形术,在一定程度上降低了重睑皱褶变浅、消失等并发症,值得临床应用。

Objective To explore the clinical application of the principle of priority of mechanics in open blepharoplasty.Methods A retrospective analysis was performed on 96 patients with bilateral single eyelid.For patients with condylar epidermis,the modified Park method for epidermal epidermal correction was performed;for patients with mild ptosis,levator aponeurosis or levator aponeurosis was performed.Methods such as loosening adhesions,reducing tissues,reducing load,and increasing the strength of the meibomian plate through surgery can weaken the mechanical factors that affect the formation of double eyelid folds.Therefore,with less or even the use of suture force,the patient achieves a more ideal shape of the double eyelid folds when the eyes are opened.Results The morphology of upper eyelids and skin sagging in all 96 patients were significantly improved.Among them,2 cases had poor curvature of the double eyelid after operation,1 had narrow double eyelid due to insufficient peeling,and 2 had bilateral asymmetry.The upper and lower eyelids of the other patients had natural morphology with open and closed eyes,scars of incisions were not obvious,and the results were satisfactory.Conclusions During mild blepharoptosis correction combined with double eyelid surgery,The use of the principle of priority of mechanics to open the double blepharoplasty can reduce the incidence of complications such as shallowing and disappearing of double eyelid folds to a certain extent,and it is worth popularizing.