重睑成形术联合V-Y内眦赘皮矫正术治疗单睑伴内眦赘皮临床研究

Double eyelid plasty combined with V-Y epicanthoplasty in the treatment of single eyelid withepicanthus

目的分析眼轮匝肌-上睑提肌固定(Park)重睑成形术+V-Y内眦赘皮矫正术治疗单睑伴内眦赘皮患者的效果。方法选取我院78例单睑伴内眦赘皮患者(2018年10月~2020年5月),依照随机抽签法将其分为两组,各39例。两组均接受Park重睑成形术治疗,同时,对照组接受Z成形术,观察组接受V-Y内眦赘皮矫正术,比较两组治疗效果。结果(1)疗效:两组治疗总有效率对比,差异无统计学意义(P>0.05);(2)眼裂变化、内眦间距:术后3个月,与对照组对比,观察组眼裂长度较长,倾斜度、眼裂角、内眦间距较小(P<0.05);(3)瘢痕变化:术后1个月,两组温哥华瘢痕量表(VSS)评分较术后1周均有所降低,但组间对比无明显差异(P>0.05),而术后3个月,两组瘢痕程度均有所减少,且观察组VSS评分较对照组低(P<0.05);(4)并发症:两组并发症发生率对比,观察组较对照组低(P<0.05)。结论Park重睑成形术+V-Y内眦赘皮矫正术治疗单睑伴内眦赘皮,能有效恢复眼裂、内眦间距,减少并发症,且瘢痕小、效果确切,具有临床推广应用价值。

Objective To analyze the effect of double eyelid plasty with orbicularis oculi levator superioris fixation+V-Y epicanthoplasty in the treatment of patients with single eyelid and epicanthus.Methods A total of 78 patients with single eyelid and epicanthus in our hospital(from October 2018 to May 2020)were selected and divided into two groups according to random drawing method,with 39 cases in each group.Both groups received double eyelid plasty with orbicularis oculi levator superioris fixation.Meanwhile,the control group received Z-plasty,and the observation group received V-Y epicanthoplasty.The treatment effects of the two groups were compared.Results(1)Curative effect:There was no statistically significant difference in the total effective rate between the two groups(P>0.05).(2)Changes in eye cleft and internal canthus distance:Compared with the control group at 3 months after operation,the length of the eye cleft in the observation group was longer,and the inclination,eye cleft angle,and internal canthus distance were smaller(P<0.05).(3)Scar changes:One month after surgery,the Vancouver Scar Scale(VSS)scores of the two groups were reduced compared with the one week after the operation,but there was no significant difference between the groups(P>0.05).3 months after surgery,the degree of scars in both groups was reduced,and the VSS score of the observation group was lower than that of the control group(P<0.05).(4)Complications:The comparison of the incidence of complications between the two groups was lower in the observation group than in the control group(P<0.05).Conclusion Double eyelid plasty with orbicularis oculi levator superioris fixation+V-Y epicanthoplasty in the treatment of single eyelid with epicanthus can effectively restore the eye fissure and inner canthus distance,reduce complications,with small scar and definite effect,and has clinical application value.