眼轮匝肌肌皮瓣与“风筝”皮瓣联合重睑成形术修复眼睑肿块切除后眼睑前层缺损的效果对比

Comparison of the effect of orbicularis oculi myocutaneous flap and"Kite"flap combined with double eyelid plasty in the repair of eyelid anterior layer defect after eyelid mass resection

目的对比分析眼轮匝肌肌皮瓣与"风筝"皮瓣联合重睑成形术修复眼睑肿块切除后眼睑前层缺损的临床效果。方法选择2018年3月至2019年9月到我院进行修复治疗的36例眼睑肿块切除后眼睑前层缺损患者为研究对象,根据其术式不同进行分组,A组(n=20)采用眼轮匝肌肌皮瓣联合重睑成形术进行修复治疗,B组(n=16)采用"风筝"皮瓣联合重睑成形术进行修复,比较两组术中出血量、手术时间、术后皮肤存活率以及患者满意度。结果A组术中出血量11.75±2.17ml、手术时间44.70±7.55min明显少于B组术中出血量17.69±2.89ml、手术时间54.19±6.68min(P<0.05)。两组皮瓣存活率100%,对比无明显的差异(P>0.05)。A组术后并发症发生率5%明显少于B组31.25%(P<0.05)。A组患者对术后外观满意度95.0%,较B组68.75%明显升高。结论眼轮匝肌肌皮瓣与"风筝"皮瓣联合重睑成形术均能够良好地修复眼睑肿块切除后皮肤缺损,皮瓣存活率高,但采用眼轮匝肌肌皮瓣联合重睑成形术术中出血量更少,术后患者满意度更高,值得推广应用。

Objective To compare and analyze the clinical effect of orbicularis oculi myocutaneous flap and"Kite"flap combined with double eyelid plasty in the repair of anterior eyelid defect after eyelid mass resection.Methods From March 2018 to September 2019,36 patients with eyelid anterior layer defect after eyelid mass resection were selected as the research objects,and they were divided into groups according to their different surgical methods.Group A(n=20)was treated with orbicularis oculi myocutaneous flap combined with blepharoplasty.Group B(n=16)was treated with"Kite"flap combined with blepharoplasty.Compare the amount of bleeding,operation time,skin survival rate and patient satisfaction.Results The blood loss(11.75±2.17 ml)and operation time(44.70±7.55 min)in group A were significantly less than those in group B(17.69±2.89 ml)and operation time(54.19±6.68 min)(P<0.05).There was no significant difference in flap survival rate(100%)between the two groups(P>0.05).The postoperative complications in group A(5%)was significantly lower than that in group B(31.25%)(P<0.05).The satisfaction rate of group A was 95.0%,which was significantly higher than that of group B(68.75%).Conclusion The orbicularis oculi myocutaneous flap and kite flap combined with double eyelid plasty can repair the skin defect after eyelid mass resection,and the survival rate of flap is high.However,the orbicularis oculi myocutaneous flap combined with double eyelid plasty has less blood loss and higher patient satisfaction,which is worthy of promotion and application.